TUESDAY, Feb. 12 (HealthDay News) -- People who donate corneas
are giving the gift of sight, but they may also be passing along a
serious infection to the recipients, a new study finds.
This infection, called endophthalmitis, most commonly comes from
donors who die in a hospital or had cancer, according to the report
in the February issue of the
Archives of Ophthalmology. Endophthalmitis is a rare but
serious complication of corneal transplant surgery and can result
in loss of vision or blindness in the affected eye.
"A national study over a decade showed that serious infection
with endophthalmitis, after corneal transplant surgery, is
uncommonly reported, but can be caused by a range of microbes,
including bacteria and fungi," said study co-author Dr. Kirk R.
Wilhelmus, a professor of ophthalmology at Baylor University
College of Medicine in Houston. "The chance for infection is higher
if eye tissue donations came from decedent donors who died in the
hospital or with advanced cancer," he added.
For the study, the researchers used data from a registry that
collected information on cases of eye infection after transplants
done between 1994 and 2003. Over the 10 years, eye banks
distributed 340,174 corneas in the United States and 109,009 in
other countries. There were a total of 162 cases of endophthalmitis
reported during that time.
The odds that someone was infected by a donor who had been
hospitalized were three times greater when compared with a
recipient who was not infected. Moreover, getting an infection was
substantially more likely if the donor had died from cancer, the
researchers found.
Although infections are rare, they do occur, and may be due to
infections picked up in the hospital. "Donor tissue can harbor
microorganisms that can persist despite antiseptics, sterile
procedures, and antibiotics," Wilhelmus said.
Still, corneal transplant surgery is largely a safe and
effective procedure, but infection is possible Wilhelmus said. "Eye
banking procedures appropriately include quality control procedures
for screening potential donors," he said.
To reduce the risk of infection, donors who had blood or other
infections are often not allowed to donate corneas. Also,
antiseptic tools are used when removing the cornea from the donor
and preserving it before transplant.
One expert thinks that because the risk of infection is so
small, patients should not fear having corneal transplant
surgery.
"The number of infections is very small," said Dr. Joel Sugar, a
professor of ophthalmology and visual science at the University of
Illinois at Chicago Eye Center and author of an accompanying
editorial in the journal. "The Eye Bank Association of America has
a very stringent and effective system for reporting such
cases."
People who die in hospitals or from cancer make up the largest
number of cornea donors, Sugar noted.
"To eliminate those categories for this low-risk event does not
make sense. It does highlight, however, the ongoing need to be
vigilant in looking for risk factors for infections and doing
everything we can to reduce the frequency of infections, even
though they are exceedingly small," he said.
Another report in the same issue of the journal concludes that
older white people are more likely to develop advanced forms of
age-related macular degeneration than black people.
In the study, Dr. Susan B. Bressler, of Johns Hopkins University
School of Medicine, and colleagues found that whites 65 and older
were more likely to have advanced macular degeneration than blacks
-- 1.7 percent versus 1.1 percent, respectively.
What's more, a form of macular degeneration called geographic
atrophy was more common among whites than blacks -- 1.8 percent
compared to 0.3 percent, the researchers found.
"Such data strongly suggest that white individuals are more
likely to progress to advanced vision-disabling age-related macular
degeneration (certainly to geographic atrophy) than black
individuals," Bressler's team concluded. The researchers also
suggested that blacks may have a mechanism that protects them from
age-related macular degeneration and other eye problems.
More information
For more on corneal transplants, visit the
U.S. National Eye Institute.