Abstract
Purpose To analyse the microbiologic control results taken during the processing of hypothermic and cultured corneas for endothelial transplants comparing the two groups from January to September 2022.
METHODS The microbiological controls of hypothermic corneas prepared for DSAEK or DMEK are: Transport Eusol control (pre-manipulation) and new Eusol control (post-manipulation). In cultured corneas the number of controls is increased to 4: first culture medium, evaluation culture medium, transport medium 24 hours post-evaluation and transport medium post-manipulation.
RESULTS A total of 1438 corneas were processed for transplant during the 9 months studied (321 fresh corneas and 1113 cultured corneas). A total of 557 corneas were prepared for DSAEK or DMEK, from which 89 (15,98%) were hypothermic corneas and 468 (84.O2%) were cultured. From hypothermic corneas, 65 were cut for DSAEK and with 24 corneas, pre-stripping for DMEK was done. In the case of cultured corneas, 187 were cut for DSAEK and with 281 pre-stripping for DMEK was done. The number of corneas with positive results in the microbiological controls were 15 (16,85%) in the case of fresh corneas (in 7 corneas that were prepared for DSAEK and in 8 for DMEK) and 4 cases (0,85%) in cultured corneas (in 3 corneas for DSAEK and in 1 corneas for DMEK) resulting in a clear difference between both preservation methods. Bio-surveillance notifications notified during the studied period have been a total of 5, from which 2 were SAE in hypothermic corneas and other 2 were SAE and 1 SAR, in cultured corneas, all for endothelial transplantations.
Conclusion The number of positive results for microorganisms was higher in the case of hypothermic corneas and the Bio-surveillance notifications were also a little bit higher in hypothermic corneas (2,25%) comparing to organ cultured corneas (0.64%). The management of an eye bank with both preservation systems is challenging with its advantages and disadvantages. The main disadvantage of hypothermic corneas is the risk of not detecting contaminations because the corneas are released without any definitive results but it is compensated by the fact that they allow us to respond to emergencies, tissue returns, apart from the economic aspect.
