The Prevalence and Risk Factors for Donor Corneal Button Contamination and Its Association With Ocular Infection After Transplantation

Rehany, Uri; Balut, Geries; Lefler, Eli; Rumelt, Shimon

doi:10.1097/01.ico.0000139633.50035.cf

Cited by 74 publications

(52 citation statements)

References 21 publications

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“…However, it remains a major concern in corneal transplantation. [15][16][17][18][19][20] In the current study, postoperative bullous keratoplasty (9/14, 64.3%) was the major risk factor for keratitis due to ocular surface diseases with recurrent erosion of the epithelium. 21,22 Fusarium infection is the most common pathogen leading to cornea perforation (28.8%), followed by P. aeruginosa keratitis (21.4%).…”

Section: Resultsmentioning

confidence: 99%

Eye preservation tectonic graft using glycerol-preserved donor cornea

Hc¹,

Sj²,

Chao³

2012

Eye

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Aims To report the surgical outcome of tectonic graft using glycerol-preserved donor corneas to treat perforated keratitis. Methods The medical records were reviewed of all patients treated for perforated keratitis using glycerol-preserved corneas at a single institution between 1 July 2004 and 31 June 2010. The clinical features, precipitating factors, adjuvant therapies, and therapeutic outcomes were analyzed. Success was defined as re-epithelialization of the ocular surface without evisceration. Results Fourteen eyes from 14 patients (6 male and 8 female) were included. Age ranged from 58 to 84 years (average, 70.71±8.52 years) and the follow-up time ranged from 7 to 56 months (mean, 25.35 ± 16.84 months). The culture results showed five bacterial infections, five cases of fungal keratitis, and one mixed infection; the culture results were negative for three patients. Satisfactory anatomical integrity was obtained in eight grafts (57.14%) that healed with neovascularization. Six grafts (48.85%) showed delayed re-epithelialization and were repaired with conjunctival flaps to maintain ocular surface integrity. Three patients developed secondary glaucoma and received trans-scleral cyclophotocoagulation. Thirteen patients had satisfactory anatomical integrity without evisceration or exenteration, while one patient received evisceration at 39-month follow-up because of intractable glaucoma. Conclusions Glycerol-preserved donor corneas combined with anterior vitrectomy with or without conjunctival flaps may be effective substitutes for evisceration surgery in patients with perforated keratitis.

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Section: Resultsmentioning

confidence: 99%

Eye preservation tectonic graft using glycerol-preserved donor cornea

Hc¹,

Sj²,

Chao³

2012

Eye

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“…S. pneumonia on the other hand is the major cause of corneal ulcers in developing countries however, some reports emphasize on the fact that Streptococcus are most commonly encountered after P. aeruginosa and/or S. aureus eye infections [14,114,215]. Unlike P. aeruginosa, pneumococcal keratitis is not commonly associated with the use of contact lenses and the predisposing factors often include ocular trauma or surgery [31,104,114,125,160,207].…”

Section: Bacterial Keratitismentioning

confidence: 99%

Pathogenesis of microbial keratitis

Lakhundi

Siddiqui

Khan

2017

Microbial Pathogenesis

171

121

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Microbial keratitis is a sight-threatening ocular infection caused by bacteria, fungi, and protist pathogens. Epithelial defects and injuries are key predisposing factors making the eye susceptible to corneal pathogens. Among bacterial pathogens, the most common agents responsible for keratitis include Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumonia and Serratia species. Fungal agents of corneal infections include both filamentous as well as yeast, including Fusarium, Aspergillus, Phaeohyphomycetes, Curvularia, Paecilomyces, Scedosporium and Candida species, while in protists, Acanthamoeba spp. are responsible for causing ocular disease. Clinical features include redness, pain, tearing, blur vision and inflammation but symptoms vary depending on the causative agent. The underlying molecular mechanisms associated with microbial pathogenesis include virulence factors as well as the host factors that aid in the progression of keratitis, resulting in damage to the ocular tissue. The treatment therefore should focus not only on the elimination of the culprit but also on the neutralization of virulence factors to minimize the damage, in addition to repairing the damaged tissue. A complete understanding of the pathogenesis of microbial keratitis will lead to the rational development of therapeutic interventions. This is a timely review of our current understanding of the advances made in this field in a comprehensible manner. Coupled with the recently available genome sequence information and high throughput genomics technology, and the availability of innovative approaches, this will stimulate interest in this field.

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“…They had done culture of corneoscleral rim, which showed Klebsiella the sensitivity pattern of which matched with the isolate from the transplanted graft. [5] Although, literatures show that donor corneoscleral rim culture report lacks predictability about postoperative infections,[67] the donor cornea could be the reason for contamination in their case. In eye bank from where we obtained donor cornea, corneoscleral culture is not routinely done.…”

Section: Discussionmentioning

confidence: 99%

A case of acute postoperative keratitis after deep anterior lamellar keratoplasty by multidrug resistant Klebsiella

Bajracharya¹,

Sharma²,

Gurung³

2015

Indian J Ophthalmol

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A healthy lady of 42 years underwent deep anterior lamellar keratoplasty for granular dystrophy. The very next day, it was complicated by development of infectious keratitis. The organism was identified as multidrug resistant Klebsiella pneumoniae. Donor corneal button may be implicated in the transmission of infection in an otherwise uneventful surgery and follow-up. Nosocomial infections are usually severe, rapidly progressive and difficult to treat. Finally, the lady had to undergo therapeutic penetrating keratoplasty for complete resolution of infection.

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The Prevalence and Risk Factors for Donor Corneal Button Contamination and Its Association With Ocular Infection After Transplantation

Abstract: Postkeratoplasty infection of the recipient eye is infrequent despite relatively high prevalence of microbial contamination of the corneal buttons, suggesting that other risk factors for postoperative ocular infection are involved.

Cited by 74 publications

References 21 publications

Eye preservation tectonic graft using glycerol-preserved donor cornea

Eye preservation tectonic graft using glycerol-preserved donor cornea

Pathogenesis of microbial keratitis

A case of acute postoperative keratitis after deep anterior lamellar keratoplasty by multidrug resistant Klebsiella

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