1. To study demographic profile of eye donors and to evaluate clinical and microbiological spectrum of donor corneas Namrata Sharma,Amarendra Samal, Rasik Vajpayee, Jeewan S Titiyal, Radhika Tandon,Gita Satpathy,Seema Sen Dr. R.P. Centre for Ophthalmic Sciences AIIMS,New Delhi None of the authors have any financial/ proprietary interest

2.  National eye bank, RPC 600-700 eyes obtained annually  Current method of decontamination : Amikacin + Betadine  Emergence of resistance to gentamicin and amikacin  Gatifloxacin is 4 th generation fluoroquinolone, acts by inhibiting DNA gyrase enzyme

3.  To evaluate  Demographic profile of eye donors  Clinical & microbiological profile of donor corneas  Efficacy of 0.3 % gatifloxacin in decontamination of donor corneas

4.  Inclusion criteria  Donor eyes received at National Eye Bank,RPC between March 2005 & August 2006  Exclusion criteria  Eyes received from areas other than Delhi  Long death processing time(>30hr)  Eyes with poor endothelial status  Positive donors with HIV,HBsAg,HCV,Syphilis

5.  1 st swabs (A1:Right &B1:Left eye )  1% Betadine for 3min+ 1% Amikacin for next 3min  Saline wash  2 nd swabs (A2:Right & B2:Left eye)  Right eye :0.3% Gatifloxacin,5-8 eye drops over 5 mins  3 rd swab taken (A3)  Corneal button were excised and stored in MK media

6.  513 pairs of eyes ( 1026 eyes )  16 pairs of eyes : Systemic malignancy  8 pairs of eyes : Confirmed septicemic donors  Prior pledging were obtained in 1.6% cases  Prior knowledge about eye donation were obtained  58 % : Grief Counselling  42% : Self Motivation

8. Grade Descemet’s foldsCorneal thicknessStromal haze Excellent (A+)NoneNil Very good (A)NoneIncreased 10%Nil Good (B+) Mild peripheral descemet’s fold Few paracentral folds, disappear on pressure Increase 10-25%Nil Fair (B) Moderate peripheral folds and Few central folds that disappear on pressure Increase 25-33% Mild stromal edema + NSFS (B–) Folds reaching center persist with increase in pressure Increase 33-50%Edema ++

9. Total no. of eyes = 513 pairs

15. 1 st swab RT 2 nd swab RT 3 rd swab RT 1 st swab LT 2 nd swab LT Pseudomo30.427.113.331.227.9 St. alb 1612.74.311.79.2 Alkligens2.92.703.12.3 Enerococi1.21.20.61.20.6 St. aureus 1.91.21.42.11.8 St. viridans 0.60.40.20.60.4 Acinebacte2.31.61.61.61.8 E. Coli 1.40.80.20.60.2 Klebsiella1.40.40.21.60.4 Pneumoco0.60.60.40.60.6 Candida0.20.40.20.40.6 Fusarium000.200 Preptococi1.20.40.40.80.4 Micrococi0.20.80.400.2 Growth +ve 6050.323.255.446.4 A1 & A2 i.e. p = 0.155 A2 & A3 i.e. p = 0.001 A2 & B2 i.e. p = 0.571 B2 & A3 i.e. p = 0.001 A1 & B1 i.e. p = 0.471 A1 & A3 i.e. p = 0.001

16.  Most common:Pseudomonas(52%),Staphylococcus albus(24%)  No difference between left and right eye (p=0.153)  Significant difference in culture positivity in both eyes after treatment with betadine(p=0.002 & 0.049 in rt & lt eyes )  Significant difference(p=0.001) found in culture positivity after treatment with gatifloxacin

17. A1A2A3B1B2Avg.Pseudomo92.288929495.592 St. alb 97.592.51009591.195.2 Alkligens93.310010010010099 Enerococi100100100100100100 St. aureus 907885.71008886.3 St. viridans 100100100100100100 Acinebacte100100100100100100 E. Coli 100100100100100100 Klebsiella100100100100100100 Pneumoco100100100100100100 Preptococi100100100100100100 Micrococi100100100100100100

19.  19 pairs of eyes found to have multiple drug resistance to all 4 drugs used  All are sensitive to Polymyxin B  5 pairs were sensitive to amikacin  63%were accidental death with young donor  65% were of death enucleation time less than 6hr

20.  Gatifloxacin 0.3 % can be used effectively for microbial contamination of donor eyes