RESUMO
A simple method has been developed to reduce contamination in postmortem donor human eyes in anticipation of corneal transplantation. In vivo investigation of albino rabbits demonstrates that vigorous saline solution irrigation is extremely effective in decreasing the surface bacterial counts of the postmortem eye. In vitro and in vivo studies show that Neosporin kills bacteria at room temperature and further show that a tenfold increase in the thimerosal concentration of the Neosporin will kill fungus. Postmortem eyes contaminated by pathogenic organisms can be effectively cleaned by a combination of saline solution irrigation and the new Neosporin-thimerosal solution. No substantial damage of the donor tissue was noted by scanning electron microscopy. Human eyes cultured before this procedure were all contaminated, but after cleansing and immersion, no bacterial or fungal growth occurred.
Assuntos
Antissepsia/métodos , Assepsia/métodos , Infecções Bacterianas/prevenção & controle , Transplante de Córnea , Soluções Oftálmicas , Preservação de Tecido , Animais , Avaliação de Medicamentos , Etanol , Gramicidina , Neomicina , Polimixina B , Coelhos , Temperatura , Irrigação Terapêutica , Timerosal , Transplante HomólogoRESUMO
As a result of the widespread use of M-K (McCarey-Kaufman) medium preserved corneas, as well as other methods of preserving corneas in a viable state, I developed a corneal holder to facilitate the lamellar dissection of previously excised whole human corneas. Consisting of a moderately heavy base, cutting pedestal, scleral rim-sealing sleeve, and retaining ring, the corneal holder is economically manufactured, simple to use, and easily sterilized. Its weight and construction allow unassisted dissection of a lamellar graft of any size.
Assuntos
Transplante de Córnea , Oftalmologia/instrumentação , Equipamentos Cirúrgicos , Preservação de Tecido/instrumentação , HumanosRESUMO
One hundred twenty-seven cultures were taken from donor eyes in McCarey Kaufman (M-K) media and 60 from anterior chamber cultures of whole eyes. From the 127 eyes, 17 positive culture were obtained, 13 of which came from anterior chamber cultures of the whole eye and 4 from the M-K media. Of the 16 eyes used for corneal transplantation, there was 1 successfully treated clinical corneal infection. It is concluded that patients with chronic debilitating disease possibly have terminal bacteremia and donor contamination. It is our current recommendations that all corneas obtained in tissue culture media be cultured by the eye bank upon arrival and that eyes prepared for M-K media and refrigerated whole eyes have an anterior chamber culture. Any positive results should then be sent to the primary surgeon as soon as the culture results are ascertained.