Clostridium perfingens

Case 1: impaired vision, lid chemosis, conjunctival injection, hyphema, diffuse infiltration and necrosis of host cornea and loose sutures, complete melt of the graft leading to enucleation, which showed Gram positive rods. C. perfringens grew from donor rim and storage medium. Patient corneal culture and intraoperative culture grew C. perfringens. Case 2: severe mucopurulent drainage, conjunctival injection and eye pain. Intravitreal sample cultured: no growth but patient was treated with antibiotics. C. perfringens grew from donor rim and storage medium, but the recipient refused enucleation. Facial and lid cellulitus developed leading to enucleation on POD 13, showing extensive Gram positive rods throughout the globe. Case 3: pain, visual blurring and hypopyon. Culture of patient vitreous and acqueous showed no growth. Culture of donor rim and storage medium showed six bacterial species plus rare C. perfringens. Treatment with antibiotics was successful.