Infectious disease risk factors of corneal graft donors.

OBJECTIVE: To determine how donor health status affects the risk of infection after corneal transplant. METHODS: An adverse reaction surveillance registry was used to conduct a matched case-control study among transplanted donor corneas from January 1, 1994, to December 31, 2003. Cases comprised 162 reports of endophthalmitis after penetrating keratoplasty including 121 with microbial recovery, of which 59 had concordant donor and recipient microbial isolates. Two controls were matched to each case by surgery date. Conditional logistic regression estimated adjusted odds ratios with 95% confidence intervals according to the premortem status of decedent donors. RESULTS: Postkeratoplasty endophthalmitis was associated with recent hospitalization (odds ratio, 2.84; 95% confidence interval, 1.61-4.98) and fatal cancer (odds ratio, 2.46; 95% confidence interval, 1.53-3.97) among donors. Endophthalmitis appeared more likely with tissues transplanted longer than 5 days after donation (odds ratio, 1.55; 95% confidence interval, 1.02-2.35). The prevalence of concordant microbial isolates from donors and recipients was greater among fungal endophthalmitis than among bacterial endophthalmitis (P < .001). CONCLUSIONS: Corneal grafts with eye tissue obtained from donors dying in the hospital or with cancer may have an increased risk of postsurgical endophthalmitis, possibly due to donor-to-host microbial transmission. Together with donor screening and processing, improvements in microbiological control may reduce infection associated with corneal transplant.

Pachymetry of donor corneas: effect of ethnicity and gender on central corneal thickness.

PURPOSE: To examine demographic differences associated with the central corneal thickness (CCT) of donor corneas and to investigate whether these differences confirmed previous clinical studies. METHODS: CCT was prospectively measured using noncontact pachymetry among 704 eye bank corneas. The effects of gender, ethnicity, age, cause of death, times until preservation and evaluation, and endothelial cell density and morphometry on CCT were examined. RESULTS: The CCT of black women was significantly thinner (P = 0.05) than that of other corneal donors. The average CCT +/- SD of black women was 530 +/- 35.9 microm, whereas those of white and Hispanic women were 554 +/- 59.1 microm and 556 +/- 51.2 microm, respectively. Average values for black, white, and Hispanic men were 553 +/- 44.7 microm, 551 +/- 53.4 microm, and 543 +/- 50.4 microm, respectively. Age and cause of death did not significantly affect CCT. CONCLUSION: Gender may modify racial differences of CCT. Measurements using donated corneal tissues support pachymetric differences by ethnic origin, although this finding was limited to female donors only.