Review of the risk of HIV infection through corneal transplantation in the United States

BACKGROUND: Human immunodeficiency virus (HIV), the pathogen that causes acquired immunodeficiency syndrome (AIDS), has been isolated in the corneal epithelium of some HIV-positive patients. This observation raises concern about the risk of HIV transmission through corneal transplantation surgery (penetrating keratoplasty). METHODS: A comprehensive review of the literature of the ocular transmission of HIV, screening of donor corneas, and the potential of HIV transmission through penetrating keratoplasty was conducted and analyzed to review and interpret the relative risk of HIV infection through corneal transplantation. RESULTS: No cases of HIV transmission were found as a result of routine eye care or ophthalmic surgical procedures, including HIV-serp-negative recipients who inadvertently received HIV-seropositive corneas. CONCLUSIONS: While ocular transmission of HIV appears to be remote, there are still relative risks of HIV transmission due to ophthalmic surgical procedures. Careful screening of donors for HIV infection affords an important increase in the margin of safety for corneal transplantation recipients.