Mathes Kristin J, Tran Khoa D, Mayko Zachary M, Stoeger Christopher G, Straiko Michael D, Terry Mark A
Lions VisionGift, Portland, OR.
Cornea Services, Devers Eye Institute, Portland, OR.
Cornea. 2019 Mar;38(3):263-267. doi: 10.1097/ICO.0000000000001839.
To examine postoperative reports of infection rates for eye bank-prepared and non-eye bank-prepared corneas from January 1, 2006 to December 31, 2017, from a single eye bank.
A retrospective review of reported fungal and bacterial infections with corneal transplant surgeries using corneas distributed by our eye bank was conducted. The reported number of infections for corneas that underwent eye bank preparation (pre-cut and pre-stripped corneas) and for those distributed without eye bank preparation was quantified. The potential association between infection rates in tissue prepared by the eye bank and those in corneas that had no additional eye bank processing was also examined.
Four of 17,035 corneas distributed during the study period were associated with fungal infections (1 eye bank-prepared and 3 non-eye bank-prepared corneas) and were attributed to the tissue after investigation by eye bank medical directors. There was no ascending trend of infections reported with eye bank-prepared corneas in the first 3 years (2 of 1054 corneas, 0.19%) compared with that in the last 3 years of the study period (6 of 3500 corneas, 0.17%; P = 0.901) when the eye bank distributed 3 times more prepared corneas than non-eye bank-prepared corneas. A significant increase in the numbers of reported infections for non-eye bank-prepared corneas was observed between these 3-year intervals (0.1% in the first 3 years to 1.58% in the last 3 years; P = 0.001).
Reports of infections remained low despite increased use of eye bank-prepared tissue. These results suggest that factors other than eye bank tissue preparation should be considered when investigating potential sources of pathogen contamination in donor corneas.
研究2006年1月1日至2017年12月31日期间,来自单一眼库的经眼库处理和未经眼库处理的角膜的术后感染率报告。
对使用我们眼库分发的角膜进行角膜移植手术的真菌和细菌感染报告进行回顾性研究。对经眼库处理(预切割和预剥离角膜)的角膜以及未经眼库处理而分发的角膜的报告感染数量进行量化。还研究了眼库处理的组织与未经过额外眼库处理的角膜的感染率之间的潜在关联。
在研究期间分发的17,035只角膜中,有4只与真菌感染有关(1只经眼库处理的角膜和3只未经眼库处理的角膜),经眼库医学主任调查后归因于组织。在研究的前3年中,经眼库处理的角膜报告的感染率没有上升趋势(1054只角膜中有2只,0.19%),而在研究期的最后3年中(3500只角膜中有6只,0.17%;P = 0.901),此时眼库分发的经处理角膜数量是非经眼库处理角膜数量的3倍。在这两个3年间隔期间,未经眼库处理的角膜报告的感染数量显著增加(从前3年的0.1%到最后3年的1.58%;P = 0.001)。
尽管眼库处理的组织使用增加,但感染报告仍然很低。这些结果表明,在调查供体角膜病原体污染的潜在来源时,应考虑眼库组织处理以外的因素。