Comparing Different Decontamination Procedures in Harvesting Human Donor Cornea

• Published in: Current eye research 2016-09, Vol.41 (9), p.1173-1177
• Main Authors: Laubichler, Peter, Arend, Nicole, Vounotrypidis, Efstathios, Wertheimer, Christian, Mayer, Wolfgang J., Yu, Alice L., Remy, Matthias, de Kaspar, Herminia Minõ, Kampik, Anselm, Kook, Daniel
• Format: Article
• Language: English
• Subjects: Anti-Infective Agents, Local - pharmacology; Cornea - drug effects; Corneal Transplantation; decontamination; Decontamination - methods; enucleation; eye bank; Eye Banks; Eye Infections - prevention & control; Follow-Up Studies; Humans; povidone iodine; Povidone-Iodine - pharmacology; Prospective Studies; Tissue and Organ Harvesting - methods; Tissue Donors
• ISSN: 0271-3683; 1460-2202
• DOI: 10.3109/02713683.2015.1101773

Purpose: To evaluate the effects of current hygiene standards for the enucleation of postmortem eyes by investigating the number of microorganisms during subsequent steps of decontamination and tissue processing. Materials and methods: This prospective, non-randomized cohort study includes 184 postmortem eyes of 92 human donors. Enucleation was performed, according to an ophthalmic surgical procedure. Two groups were generated as follows: right eyes were allocated to group A, left eyes were allocated to group B. In group A, a mucosal disinfectant was used accessorily. Conjunctival smears were taken to examine germ load in both groups before any intervention, in group A after mucosal disinfection, in both groups after transportation of the whole globes in transport fluid, and in both groups after a bath in 0.75% povidone iodine solution for at least 3 minutes just before preparation of the corneoscleral disc. Smears were sent to the local microbiologic laboratory in an aseptic package for testing. Results: All smears showed multiple contaminations (n = 184/184 eyes) before treatment with povidone iodine solution. Contamination was in both groups significantly prevented using the treatment strategy of an at least 3-minute bath in 0.75% povidone iodine solution (n = 1/184 eyes; p < 0.01) As a side effect, almost every eye of group A and none of group B showed brown iodine staining corresponding to corneal epithelial erosion. Conclusions: An aseptic setting for donor enucleation similar to a surgical procedure seems not to influence the outcome of germ colonization. The most effective step to decontaminate donor eyes is to use 0.75% povidone iodine solution for at least 3 minutes.