Endophthalmitis from contaminated donor corneas following penetrating keratoplasty

We encountered six (0.2%) cases of endophthalmitis resulting from contaminated donor corneas between January 1983 and July 1990 following a total of 3000 consecutive penetrating keratoplasties. Causative organisms in the three cases of fungal endophthalmitis were Torulopsis glabrata, Candida albicans, and Aspergillus flavus; the three cases of bacterial endophthalmitis were due to Klebsiella pneumoniae, Staphylococcus aureus, and Enterococcus faecalis. All organisms were resistant to gentamicin in the preservation media. A significantly higher incidence of endophthalmitis was noted in patients receiving corneas from a Sri Lankan eye bank (1.25%) than in those receiving US eye bank tissue (0.14%). Donor rim cultures are important to identify those patients at increased risk of developing endophthalmitis, enabling earlier diagnosis and more specific treatment should endophthalmitis occur.