Incidence and Outcomes of Transplant of Infected Donor Corneal Tissues in a Tertiary Hospital in Saudi Arabia

Purpose: The aim of this study is to assess donor rim culture results and predict ocular infections after corneal transplantation to determine the relationship between positive corneoscleral rim cultures and post-keratoplasty infection. Design: This is a retrospective study. Methods: The microbiology results of positive donor rim culture and clinical outcomes of all contaminated grafts at Dhahran Eye Specialist Hospital (DESH) in the Eastern Region of Saudi Arabia between October 2016 and February 2020 were reviewed. Results: A total of 684 corneal transplantation procedures were performed at DESH during this period. Routine donor rim cultures were done for all cases with six positive cases (0.88%). There were five positive fungal donor rim cultures (0.73%), and one corneal rim was positive for both bacterial and fungal cultures (0.15%). Among these six patients, two patients (33.33%) who received graft positive with candida developed an infection. Both cases required further interventions but were unsuccessful and eventually ended up with re-grafting. Conclusion: In the sample collected, positive fungal contamination was more frequent than bacterial contamination, and the incidence of bacterial infection is relatively low compared to that of fungal infection due to contaminated grafts. Despite the limitations of our study, we support routine corneoscleral rim culture and to start prophylactic antifungal treatment in response to positive donor fungal rim culture.