{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T13:36:22Z","timestamp":1786628182232,"version":"build-2736575974"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8]]},"abstract":"\n Purpose:<\/jats:title>\n To compare the microbiological positivity of corneal smears obtained from the anterior corneal surface and the posterior (endothelial) surface of the excised corneal button in patients undergoing therapeutic penetrating keratoplasty (TPK).<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This retrospective study included patients who underwent TPK between August 2019 and January 2025 at a tertiary care center. Demographic and clinical details were retrieved from hospital and eye bank records, while microbiological data were obtained from the microbiology department. Intraoperative corneal scrapings were collected from the anterior corneal surface prior to trephination and from the posterior (endothelial) surface of the excised recipient corneal button. Smears were examined using standard staining techniques. Patients with incomplete microbiological data or noninfective indications were excluded. Microbiological findings from anterior and posterior samples were compared using the Chi-square test, with\n P<\/jats:italic>\n < 0.05 considered statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of 252 TPKs performed, 132 patients met the inclusion criteria. Trauma was the most common predisposing factor (44.5%). Anterior corneal scrapings were positive in 26.5% (n = 35) of cases, with fungal elements predominating (74.3%), followed by Gram-positive cocci and Gram-negative organisms. Posterior (endothelial) scrapings showed a higher positivity rate of 34.8% (n = 46), with fungi accounting for 89.1% of positive samples. Both samples were negative in 51.5% of cases. Posterior scrapings demonstrated significantly higher positivity than anterior scrapings (\n P<\/jats:italic>\n = 0.046). Among cases positive in both samples (n = 17), 76.1% showed concordant organisms, while 23.9% were discordant.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Posterior corneal (endothelial) scraping yields higher microbiological positivity than conventional anterior scraping and serves as a valuable adjunct. Combining both techniques may enhance pathogen detection in advanced infectious keratitis.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2756_25","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T09:00:08Z","timestamp":1785747608000},"page":"S199-S202","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of smear positivity from anterior and posterior (endothelial) corneal scrapings obtained per-operatively in patients undergoing therapeutic penetrating keratoplasty \u2013 A retrospective study"],"prefix":"10.4103","volume":"74","author":[{"given":"Pankti C","family":"Buch","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashwat","family":"Shekhar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujata","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Cornea Services, L V Prasad Eye Institute, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandu","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa","family":"Kumari","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanya","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeti","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev K","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"R1-20260813","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.survophthal.2018.12.003","article-title":"The persistent dilemma of microbial keratitis: Global burden, diagnosis, and antimicrobial resistance","volume":"64","author":"Ung","year":"2019","journal-title":"Surv Ophthalmol"},{"key":"R2-20260813","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/S0161-6420(81)34943-4","article-title":"Decision-making in the management of microbial keratitis","volume":"88","author":"Jones","year":"1981","journal-title":"Ophthalmology"},{"key":"R3-20260813","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1097\/00003226-200210000-00002","article-title":"Evaluation of corneal scraping smear examination methods in the diagnosis of bacterial and fungal keratitis: A survey of eight years of laboratory experience","volume":"21","author":"Sharma","year":"2002","journal-title":"Cornea"},{"key":"R4-20260813","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/ICU.0b013e32833a8e23","article-title":"Therapeutic keratoplasty for microbial keratitis","volume":"21","author":"Sharma","year":"2010","journal-title":"Curr Opin Ophthalmol"},{"key":"R5-20260813","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1097\/ICO.0b013e318206ccf1","article-title":"Association between culture results of corneal scrapings and culture and histopathology results of corneal tissues in therapeutic keratoplasty","volume":"30","author":"Das","year":"2011","journal-title":"Cornea"},{"key":"R7-20260813","first-page":"42","article-title":"Taking a corneal scrape and making a diagnosis","volume":"22","author":"Leck","year":"2009","journal-title":"Community Eye Health"},{"key":"R8-20260813","doi-asserted-by":"crossref","first-page":"3171","DOI":"10.4103\/IJO.IJO_1344_23","article-title":"Long-term outcomes of therapeutic corneal transplants performed in a tertiary eye care hospital in South India","volume":"71","author":"Christy","year":"2023","journal-title":"Indian J Ophthalmol"},{"key":"R9-20260813","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1007\/s10792-021-02127-y","article-title":"Clinical profile and microbiological trends of therapeutic keratoplasty at a network of tertiary care ophthalmology centers in India","volume":"42","author":"Das","year":"2022","journal-title":"Int Ophthalmol"},{"key":"R10-20260813","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/ceo.14113","article-title":"Infectious keratitis: A review","volume":"50","author":"Cabrera-Aguas","year":"2022","journal-title":"Clin Exp Ophthalmol"},{"key":"R11-20260813","first-page":"28","article-title":"Potassium hydroxide (KOH) wet preparation for the laboratory diagnosis of suppurative corneal ulcer","volume":"9","author":"Laila","year":"2010","journal-title":"Bangladesh J Med Sci"},{"key":"R12-20260813","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1016\/j.survophthal.2021.08.002","article-title":"Fungal keratitis: Mechanisms of infection and management strategies","volume":"67","author":"Donovan","year":"2022","journal-title":"Surv Ophthalmol"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2756_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T12:59:13Z","timestamp":1786625953000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2756_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":11,"journal-issue":{"issue":"Suppl 2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2756_25","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2025-10-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-21","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}