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Cohort studyScientific reports · 2026

Microbial contamination of donor corneas and post-keratoplasty endophthalmitis: a comparison between Japanese and U.S. eye banks using cold storage.

Naoya Nakagawa, Yuto Yukari, Ami Igarashi … Takahiko Hayashi

OphthalmologyCohort study

Overseas-sourced donor corneas had lower odds of microbial contamination than domestic ones

Microbial contamination of donor corneas and post-keratoplasty endophthalmitis: a comparison between Japanese and U.S. eye banks using cold storage.

Naoya Nakagawa … Takahiko Hayashi

Scientific reports · 2026

Purpose

This study evaluated the prevalence and microbial spectrum of positive corneoscleral donor rim cultures and the associated risk factors for post-keratoplasty infection in Japan.

Methods

We retrospectively included consecutive corneal transplantations performed by a single surgeon between April 2015 and September 2021.

n = 134

Results

overseas donor corneas were far less likely to test positive for bacteria

OR 0.26 (95% CI 0.14 to 0.49)

CI excludes the null - significant

More results

Overall, 78 (15.6%) were culture-positive.

Post-keratoplasty endophthalmitis occurred in three cases (0.6%), all of which were associated with positive fungal cultures.

“

Conclusion

Therefore, fungal pathogens may play a key role in increasing clinically significant postoperative endophthalmitis risk after keratoplasty, highlighting the importance of targeted donor tissue screening and postoperative management.

Microbial contamination of donor corneas and post-keratoplasty endophthalmitis: a comparison between Japanese and U.S. eye banks using cold storage.

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