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Corneoscleral rim cultures: lack of utility and implications for clinical decision-making and infection prevention in the care of patients undergoing corneal transplantation.

Publication ,  Journal Article
Everts, RJ; Fowler, WC; Chang, DH; Reller, LB
Published in: Cornea
August 2001

PURPOSE: To assess the utility of donor corneoscleral rim cultures. METHODS: A retrospective review of the culture results of 774 corneoscleral rims that remained after trephination of corneas for transplantation into patients at our academic medical center between January 1992 and November 1997. RESULTS: Forty-one (5.3%) corneoscleral rim cultures yielded microorganisms, mostly coagulase-negative staphylococci. Two patients developed endophthalmitis (one with Staphylococcus aureus and one with Pseudomonas aeruginosa) within 3 months after transplantation; each had a negative corneoscleral rim culture and neither patient's infection was temporally related to the transplant procedure. CONCLUSIONS: Preoperative donor corneoscleral rim cultures are unreliable predictors of endophthalmitis complicating corneal transplantation and, therefore, are not useful in the clinical management of patients having corneal transplants. Moreover, the discrepancy between the results of corneoscleral rim cultures and subsequent endophthalmitis renders them invalid as a quality assurance procedure. Instead, for patients with suspected endophthalmitis after corneal transplantation, we recommend that corneal surgeons select antimicrobial therapy based on current guidelines and the results of directed sampling. Furthermore, eye banks should prospectively track recipients who develop clinical endophthalmitis, immediately notify the corneal surgeon who transplanted the matched cornea of that used for the index case, and, in selected situations, attempt to identify a possible source of contamination.

Duke Scholars

Published In

Cornea

DOI

ISSN

0277-3740

Publication Date

August 2001

Volume

20

Issue

6

Start / End Page

586 / 589

Location

United States

Related Subject Headings

  • Sclera
  • Retrospective Studies
  • Quality Control
  • Quality Assurance, Health Care
  • Ophthalmology & Optometry
  • Humans
  • Eye Infections, Bacterial
  • Eye Banks
  • Endophthalmitis
  • Decision Making
 

Citation

APA
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ICMJE
MLA
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Everts, R. J., Fowler, W. C., Chang, D. H., & Reller, L. B. (2001). Corneoscleral rim cultures: lack of utility and implications for clinical decision-making and infection prevention in the care of patients undergoing corneal transplantation. Cornea, 20(6), 586–589. https://doi.org/10.1097/00003226-200108000-00006
Everts, R. J., W. C. Fowler, D. H. Chang, and L. B. Reller. “Corneoscleral rim cultures: lack of utility and implications for clinical decision-making and infection prevention in the care of patients undergoing corneal transplantation.Cornea 20, no. 6 (August 2001): 586–89. https://doi.org/10.1097/00003226-200108000-00006.
Everts, R. J., et al. “Corneoscleral rim cultures: lack of utility and implications for clinical decision-making and infection prevention in the care of patients undergoing corneal transplantation.Cornea, vol. 20, no. 6, Aug. 2001, pp. 586–89. Pubmed, doi:10.1097/00003226-200108000-00006.

Published In

Cornea

DOI

ISSN

0277-3740

Publication Date

August 2001

Volume

20

Issue

6

Start / End Page

586 / 589

Location

United States

Related Subject Headings

  • Sclera
  • Retrospective Studies
  • Quality Control
  • Quality Assurance, Health Care
  • Ophthalmology & Optometry
  • Humans
  • Eye Infections, Bacterial
  • Eye Banks
  • Endophthalmitis
  • Decision Making