Systemic Fungal Infections in Donors for Corneal Transplantation.
OBJECTIVE
To determine the prevalence of postkeratoplasty fungal infection when corneal tissue from donors with a recent medical history of oral thrush or respiratory, urine, wound, sputum, bronchial, tracheal, or throat culture positive for fungus is identified before recovery and after decontamination of the corneal tissue with 5% povidone-iodine flush to the donors' eyes during recovery.


METHODS
This is a prospective analysis of corneas from 42 donors with a documented medical history of fungus or positive fungal culture, which were recovered between January 2010 and November 2010. Standard aseptic swab of the donors' corneas before and after application of 5% povidone-iodine solution was performed. Culture results were analyzed in relationship to the donors' medical history and potential posttransplantation infections.


RESULTS
Eighty-four eyes from 42 patients were swabbed for cultures during the study period. Seven eyes (8.3%) were positive for fungal growth before treatment with 5% povidone-iodine, whereas there were no positive fungal cultures after treatment (P = 0.007). Fifty-four corneas from this study group were used for corneal transplantation. There were no cases of fungal infection in any postkeratoplasty eyes transplanted from this study group.


CONCLUSIONS
In this small study, the overall prevalence of fungal infections after corneal transplantation using corneal donor tissue from donors with a fungal-positive medical history is low. Corneal fungal contamination in donors with a history of fungal infection or a positive fungal culture can be significantly reduced with a 5% povidone-iodine flush.
*Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD; and †SightLife, Seattle, WA.
Sheila
S
Pabon
Thomas D
TD
Lindquist
Thomas D
TD
Miller
Bennie H
BH
Jeng
D000328:Adult; D003315:Cornea / Q000382:microbiology*; D009877:Endophthalmitis / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications*; D011446:Prospective Studies; D014019:Tissue Donors; D055815:Young Adult