02966nas a2200349   4500008004100000022004700041245008700088210006900175250001000244260000800254300001200262490000800274520183500282653001902117653004002136653002502176653001802201653001602219653002702235653004702262653006202309653003702371653001102408653001402419653001402433653002702447653003202474653003002506100001902536700001602555856004502571       2007                        eng d  a1549-4713 (Electronic) 0161-6420 (Linking)00aThe prognostic role of donor corneoscleral rim cultures in corneal transplantation0 aprognostic role of donor corneoscleral rim cultures in corneal t  a39141  cMar  a440 - 50 v1143 aPURPOSE: To examine the discriminatory performance of donor corneoscleral rim cultures for predicting endophthalmitis after corneal transplantation. DESIGN: Systematic literature review. PARTICIPANTS: Studies that reported the prevalence of donor rim cultures after refrigerated preservation of donor corneas distributed for keratoplasty. METHODS: Random-effects meta-analysis estimated pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Meta-regression and stratification explored study-level reasons for diagnostic performance. MAIN OUTCOME MEASURES: Incidence of postkeratoplasty endophthalmitis. RESULTS: Of 17,614 corneal grafts, 2459 (14%) had a positive donor rim culture and 31 (0.2%) developed endophthalmitis. Twenty-one had concordant donor and recipient isolates, including 10 with Candida species. The sensitivity of donor rim cultures among 10 studies reporting postsurgical endophthalmitis was 67% (95% confidence interval [CI], 47%-83%), and specificity averaged 85%. Endophthalmitis occurred 12 (95% CI, 5-29) times more often among recipients of a culture-positive donor cornea. With Bayesian analysis, a culture-positive donor cornea would raise the infection risk to 1%, whereas fungal isolation from the donor rim predicts a 3% probability of fungal endophthalmitis. Pooling of studies was limited by a significant discrepancy among reports that could not be explained by differences in antibiotic supplementation of the preservation medium, method of culture inoculation, or type of culture medium. CONCLUSION: Endophthalmitis after penetrating keratoplasty is more likely with a culture-positive donor rim, notably candidal endophthalmitis from fungal contaminants, but better evidence is needed to determine the prognostic value and manner of routine microbiological screening.10a*Tissue Donors10aBacteria / isolation & purification10aBacterial Infections10aBayes Theorem10aCandidiasis10aCornea / *microbiology10aCorneal Transplantation / *adverse effects10aEndophthalmitis / epidemiology / *etiology / microbiology10aFungi / isolation & purification10aHumans10aIncidence10aPrognosis10aSclera / *microbiology10aSensitivity and Specificity10aTissue Culture Techniques1 aWilhelmus, K R1 aHassan, S S  uhttps://notifylibrary.org/reference/1631