The value of routine donor corneal rim cultures in penetrating keratoplasty

OBJECTIVE: To investigate the value of donor corneal rim cultures performed routinely at the time of penetrating keratoplasty. DESIGN: Retrospective review of Mayo Clinic medical records for all corneal transplantations for which donor rim cultures have been performed. MAIN OUTCOME MEASURES: Frequency of positive cultures, occurrence of endophthalmitis within 2 months of undergoing surgery, action taken in response to the culture results, and costs of cultures. RESULTS: Donor rim culture results were available for 1078 of 1083 consecutive transplantations performed from 1981 to 1995. Three cases of endophthalmitis (0.28%) and 1 suture abscess occurred. Rim cultures were negative in all of these cases. Action was documented in response to positive cultures in 17 cases (8.1%). The estimated average cost of routine rim cultures in 1994 was $137 per donor cornea. Bacterial or fungal cultures were positive in 209 (19.4%) cases. Two microorganisms were cultured simultaneously in 17 cases (1.6%) and 3 in 2 cases (0.2%). Staphylococcus coagulase-negative (130 cases [12.1%]), and Streptococcus species, viridans group (23 cases [2.1%]), were the most common isolates. Fifty-two (62.7%) of 83 coagulase-negative Staphylococcus species isolates tested were resistant to gentamicin. There were more positive cultures from corneas stored in Optisol (37/183 [20%]) than in Optisol GS (16/144 [11%]) (P = .03). Fewer cultures were positive from live donors (9/93 [10%]) compared with cadaveric donors (181/ 909 [20%]) (P = .02). Positive cultures were more frequent for corneas excised in situ (39/125 [31.2%]) than for those enucleated (152/851 [17.9%]) (P