Purpose: To examine the impact of microbial contamination of donor corneal storage medium on the postoperative course of patients undergoing keratoplasty.
Patients and methods: The donor corneal storage medium was examined for the presence of bacteria or fungi by microbiological culture methods in patients who underwent keratoplasty between May 1995 and August 2014 (n=463) at Miyata Eye Hospital. The outcme of patients with storage medium positive for microorganisms was examined.
Results: Ten microorganisms were isolated from nine donor corneal storage media, of which eight bacterial strains were isolated from seven eyes and the other two were isolates of Candida species. Postoperative endophthalmitis did not develop in seven recipients who underwent grafting with the donor cornea from the storage medium positive for bacteria. In contrast, two recipients with media positive for Candida developed fungal endophthalmitis at approximately 3-4 weeks after keratoplasty and were resistant despite treatment.
Conclusions: Microbiological testing of the donor corneal storage medium is an important preoperative examination in patients undergoing keratoplasty in order to prevent postoperative endophthalmitis. Recipients with fungal strains isolated from the donor corneal storage medium are more likely to develop fungal endophthalmitis, and therefore, close observation of these patients is required for immediate intervention and treatment.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 58-63, 2019.