Pre-banking microbial contamination of donor conjunctiva and storage medium for penetrating keratoplasty

Abstract

Pre-banking microbial assessment allows for microbial detection, bacterial susceptibility and resistance testing. This is useful for developing preservation mediums containing effective spectrum antibiotic agents for high quality control of corneal banking.

Monitoring the microbial contamination of donor cornea during all preservation phases: A prospective study in the Eye Bank of Rome

“…Decontamination of the periocular area and conjunctival sac is usually performed in the mortuary room or operation theatre using povidone–iodine solutions, which effectively reduces the microbial contamination . The 67% contamination rate found in our study was much higher than all those reported by the above‐mentioned authors and it was comparable to the 77% contamination rate described by Inomata et al for corneas obtained from eye globes decontaminated with 10% povidone–iodine solution. A 67% cornea contamination rate found in the present study falls within the contamination range (52%‐77%) found before decontamination with the povidone–iodine solutions .…”

“…ally performed in the mortuary room or operation theatre using povidone-iodine solutions, which effectively reduces the microbial contamination. [12][13][14]17 The 67% contamination rate found in our study was much higher than all those reported by the above-mentioned authors 11,12,14,16,17 and it was comparable to the 77% contamination rate described by Inomata et al 25 A 67% cornea contamination rate found in the present study falls within the contamination range (52%-77%) found before decontamination with the povidone-iodine solutions. 11,14 The contamination rates did not show significant differences related to different causes of donor death at three cornea storage phases, as previously observed by other authors.…”

“…Linke et al found that the switch from whole globe explantation to the in situ corneoscleral rim excision, which is potentially more prone to contamination, temporarily raised the contamination rate of organ‐cultured corneas up to 19.4%, this rate decreased to 10.3% after specific training of staff performing all retrievals . However, the whole globe explantation, followed by cornea dissection under aseptic conditions, as described by Inomata et al, did not prevent high (77%) contamination rate of the corneas . These findings confirm that donor corneas are potentially highly contaminated tissues, and thus it is necessary to check the appropriateness of retrieval procedures of all teams involved in tissue procurement and implement corrective measures in case of nonconformity.…”

“…A 67% cornea contamination rate found in the present study falls within the contamination range (52%‐77%) found before decontamination with the povidone–iodine solutions . The contamination rates did not show significant differences related to different causes of donor death at three cornea storage phases, as previously observed by other authors . In our eye bank, 13 teams were involved in tissue procurement, and despite the training provided, it is possible that unscrupulous manoeuvres might have occurred during decontamination and/or surgical removal techniques.…”

“…11,14 The contamination rates did not show significant differences related to different causes of donor death at three cornea storage phases, as previously observed by other authors. 25 In our eye bank, 13 teams were involved in tissue procurement, and despite the training provided, it is possible that unscrupulous manoeuvres might have occurred during decontamination and/or surgical removal techniques. As already experienced in other eye banks, the donor eye decontamination is a critical step in tissue safety management, and taking corrective measures during the tissue procurement phase could successfully reduce the contamination rates.…”