Incidence and Implications of Culture-Positive Corneoscleral Rims in Corneal Transplantation

Zuheer Meeraalam,1 Shaker O Alreshidi,2 Hani B ALBalawi,3 Naif M Alali,3 Faris Hashem,3 Omar M Kirat4 1Ophthalmology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 2Ophthalmology Division, Department of Surgical Specialties, College of Medicine, Majmaah University, Majmaah, S...

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Main Authors: Meeraalam Z, Alreshidi SO, ALBalawi HB, Alali NM, Hashem F, Kirat OM
Format: Article
Language:English
Published: Dove Medical Press 2025-02-01
Series:Infection and Drug Resistance
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Online Access:https://www.dovepress.com/incidence-and-implications-of-culture-positive-corneoscleral-rims-in-c-peer-reviewed-fulltext-article-IDR
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author Meeraalam Z
Alreshidi SO
ALBalawi HB
Alali NM
Hashem F
Kirat OM
author_facet Meeraalam Z
Alreshidi SO
ALBalawi HB
Alali NM
Hashem F
Kirat OM
author_sort Meeraalam Z
collection DOAJ
description Zuheer Meeraalam,1 Shaker O Alreshidi,2 Hani B ALBalawi,3 Naif M Alali,3 Faris Hashem,3 Omar M Kirat4 1Ophthalmology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 2Ophthalmology Division, Department of Surgical Specialties, College of Medicine, Majmaah University, Majmaah, Saudi Arabia; 3Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia; 4Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaCorrespondence: Hani B ALBalawi, Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, 71491, Saudi Arabia, Email hb.albalawi@ut.edu.saBackground: Corneal transplantation is a critical procedure for restoring vision affected by different corneal pathologies. However, postoperative infections threaten graft survival, particularly microbial keratitis and endophthalmitis.Objective: This study aims to evaluate the incidence of culture-positive corneoscleral rims (CPCR) among transplanted corneas at a tertiary eye hospital and explore its association with death-preservation and preservation-surgery times.Methods: A retrospective analysis of keratoplasty surgeries performed in 2015 was conducted, involving 603 cases meeting the study criteria.Results: The incidence of CPCR was found to be 4.6%, predominantly bacterial (68%), with Methicillin-resistant Staphylococcus epidermidis (MRSE) being the most common isolate, followed by fungal (32%) species, notably Candida. However, none of the cases developed subsequent keratitis or endophthalmitis post-transplantation. Statistical analysis revealed no significant association between CPCR occurrence and death-preservation or preservation-surgery times.Conclusion: The study underscores the reduced impact of contaminated CPCR on graft outcomes, advocating for targeted fungal culturing, intraoperative practices to mitigate post-transplant infections, and maintaining current prophylactic antibiotic regimens, such as optisolGS ™, which contains streptomycin and gentamicin.Keywords: corneal transplant, keratitis, endophthalmitis, infection, bacterial keratitis
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publishDate 2025-02-01
publisher Dove Medical Press
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series Infection and Drug Resistance
spelling doaj-art-2a453748e562485f9342285f7a592d172025-02-11T17:30:55ZengDove Medical PressInfection and Drug Resistance1178-69732025-02-01Volume 18847853100102Incidence and Implications of Culture-Positive Corneoscleral Rims in Corneal TransplantationMeeraalam ZAlreshidi SOALBalawi HBAlali NMHashem FKirat OMZuheer Meeraalam,1 Shaker O Alreshidi,2 Hani B ALBalawi,3 Naif M Alali,3 Faris Hashem,3 Omar M Kirat4 1Ophthalmology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 2Ophthalmology Division, Department of Surgical Specialties, College of Medicine, Majmaah University, Majmaah, Saudi Arabia; 3Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia; 4Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaCorrespondence: Hani B ALBalawi, Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, 71491, Saudi Arabia, Email hb.albalawi@ut.edu.saBackground: Corneal transplantation is a critical procedure for restoring vision affected by different corneal pathologies. However, postoperative infections threaten graft survival, particularly microbial keratitis and endophthalmitis.Objective: This study aims to evaluate the incidence of culture-positive corneoscleral rims (CPCR) among transplanted corneas at a tertiary eye hospital and explore its association with death-preservation and preservation-surgery times.Methods: A retrospective analysis of keratoplasty surgeries performed in 2015 was conducted, involving 603 cases meeting the study criteria.Results: The incidence of CPCR was found to be 4.6%, predominantly bacterial (68%), with Methicillin-resistant Staphylococcus epidermidis (MRSE) being the most common isolate, followed by fungal (32%) species, notably Candida. However, none of the cases developed subsequent keratitis or endophthalmitis post-transplantation. Statistical analysis revealed no significant association between CPCR occurrence and death-preservation or preservation-surgery times.Conclusion: The study underscores the reduced impact of contaminated CPCR on graft outcomes, advocating for targeted fungal culturing, intraoperative practices to mitigate post-transplant infections, and maintaining current prophylactic antibiotic regimens, such as optisolGS ™, which contains streptomycin and gentamicin.Keywords: corneal transplant, keratitis, endophthalmitis, infection, bacterial keratitishttps://www.dovepress.com/incidence-and-implications-of-culture-positive-corneoscleral-rims-in-c-peer-reviewed-fulltext-article-IDRcorneal transplantkeratitisendophthalmitisinfectionbacterial keratitis.
spellingShingle Meeraalam Z
Alreshidi SO
ALBalawi HB
Alali NM
Hashem F
Kirat OM
Incidence and Implications of Culture-Positive Corneoscleral Rims in Corneal Transplantation
Infection and Drug Resistance
corneal transplant
keratitis
endophthalmitis
infection
bacterial keratitis.
title Incidence and Implications of Culture-Positive Corneoscleral Rims in Corneal Transplantation
title_full Incidence and Implications of Culture-Positive Corneoscleral Rims in Corneal Transplantation
title_fullStr Incidence and Implications of Culture-Positive Corneoscleral Rims in Corneal Transplantation
title_full_unstemmed Incidence and Implications of Culture-Positive Corneoscleral Rims in Corneal Transplantation
title_short Incidence and Implications of Culture-Positive Corneoscleral Rims in Corneal Transplantation
title_sort incidence and implications of culture positive corneoscleral rims in corneal transplantation
topic corneal transplant
keratitis
endophthalmitis
infection
bacterial keratitis.
url https://www.dovepress.com/incidence-and-implications-of-culture-positive-corneoscleral-rims-in-c-peer-reviewed-fulltext-article-IDR
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