@article {1631,
	title = {The prognostic role of donor corneoscleral rim cultures in corneal transplantation},
	journal = {Ophthalmology},
	volume = {114},
	year = {2007},
	note = {Wilhelmus, Kirk R Hassan, Sohela S EY016631/EY/NEI NIH HHS/United States EY02520/EY/NEI NIH HHS/United States Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t Review United States Ophthalmology Ophthalmology. 2007 Mar;114(3):440-5.},
	month = {Mar},
	pages = {440 - 5},
	edition = {39141},
	abstract = {PURPOSE: To examine the discriminatory performance of donor corneoscleral rim cultures for predicting endophthalmitis after corneal transplantation. DESIGN: Systematic literature review. PARTICIPANTS: Studies that reported the prevalence of donor rim cultures after refrigerated preservation of donor corneas distributed for keratoplasty. METHODS: Random-effects meta-analysis estimated pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Meta-regression and stratification explored study-level reasons for diagnostic performance. MAIN OUTCOME MEASURES: Incidence of postkeratoplasty endophthalmitis. RESULTS: Of 17,614 corneal grafts, 2459 (14\%) had a positive donor rim culture and 31 (0.2\%) developed endophthalmitis. Twenty-one had concordant donor and recipient isolates, including 10 with Candida species. The sensitivity of donor rim cultures among 10 studies reporting postsurgical endophthalmitis was 67\% (95\% confidence interval [CI], 47\%-83\%), and specificity averaged 85\%. Endophthalmitis occurred 12 (95\% CI, 5-29) times more often among recipients of a culture-positive donor cornea. With Bayesian analysis, a culture-positive donor cornea would raise the infection risk to 1\%, whereas fungal isolation from the donor rim predicts a 3\% probability of fungal endophthalmitis. Pooling of studies was limited by a significant discrepancy among reports that could not be explained by differences in antibiotic supplementation of the preservation medium, method of culture inoculation, or type of culture medium. CONCLUSION: Endophthalmitis after penetrating keratoplasty is more likely with a culture-positive donor rim, notably candidal endophthalmitis from fungal contaminants, but better evidence is needed to determine the prognostic value and manner of routine microbiological screening.},
	keywords = {*Tissue Donors, Bacteria / isolation \& purification, Bacterial Infections, Bayes Theorem, Candidiasis, Cornea / *microbiology, Corneal Transplantation / *adverse effects, Endophthalmitis / epidemiology / *etiology / microbiology, Fungi / isolation \& purification, Humans, Incidence, Prognosis, Sclera / *microbiology, Sensitivity and Specificity, Tissue Culture Techniques},
	issn = {1549-4713 (Electronic) 0161-6420 (Linking)},
	doi = {S0161-6420(06)01304-2 [pii] 10.1016/j.ophtha.2006.09.006},
	author = {Wilhelmus,K. R. and Hassan,S. S.}
}
