Newer keratoplasty techniques do not appear to increase rate of infection

This retrospective study found that newer keratoplasty techniques, despite their increased manipulation of tissue, do not appear to result in a higher rate of positive microbiologic results and subsequent infections.

The authors reviewed microbiology results from 569 consecutive corneal transplants performed in routine evaluation of cornea donor tissue.

Of the 544 cases with microbiologic results available, 46 cases (8.5 percent) were positive. In 10 of these, gram stain results were positive with subsequent negative cultures.

The prevalence of positive results was 4.4 percent for femtosecond laser-enabled keratoplasty, 11 percent for Descemet stripping automated endothelial keratoplasty, and 9.6 percent for conventional penetrating keratoplasty. None of the nine femtosecond deep anterior lamellar keratoplasty showed positive results. There was no significant relationship between type of transplant procedure and occurrence of positive microbiologic results (P = 0.08).

The overall incidence of clinical infection was 0.4 percent. However, only one case was attributable to the donor. Of 25 cases in which microbiology studies were not performed, none developed a clinical infection.

The authors say their findings suggest a potential value in performing routine fungal stains and cultures.