Candida keratitis after Descemet stripping with automated endothelial keratoplasty.

TitleCandida keratitis after Descemet stripping with automated endothelial keratoplasty.
Publication TypeJournal Article
Year of Publication2014
AuthorsVillarrubia A, Cano-Ortiz A
JournalEuropean journal of ophthalmology// Eur J Ophthalmol
Pagination964 - 7
Date Published2014//
ISBN Number1724-6016
Other Numbersbjg, 9110772
Keywords*Candidiasis/mi [Microbiology], *Corneal Ulcer/mi [Microbiology], *Descemet Stripping Endothelial Keratoplasty/ae [Adverse Effects], *Eye Infections, Fungal/mi [Microbiology], Aged, Antifungal Agents/tu [Therapeutic Use], Candidiasis/di [Diagnosis], Candidiasis/th [Therapy], Combined Modality Therapy, Corneal Ulcer/di [Diagnosis], Corneal Ulcer/th [Therapy], Eye Infections, Fungal/di [Diagnosis], Eye Infections, Fungal/th [Therapy], Female, Humans, Keratoplasty, Penetrating, Lens Implantation, Intraocular, Phacoemulsification, Reoperation, Tissue Donors, Voriconazole/tu [Therapeutic Use]

PURPOSE: To report a case of Candida albicans keratitis after Descemet stripping with automated endothelial keratoplasty (DSAEK) due to fungal contamination of the donor cornea., METHODS: Case report., RESULTS: A 73-year-old woman underwent phacoemulsification with intraocular lens (IOL) implantation and DSAEK with 1 week difference. Ten days after DSAEK surgery, the culture of the donor corneoscleral rim revealed Candida albicans contamination and a small whitish infiltrate was noted within the interface. Despite conservative treatment with oral and systemic voriconazole, the infection was present outside the interface and inside the anterior chamber. Hot penetrating keratoplasty (PKP) was performed and the infection was eradicated. However, due to uncontrolled high intraocular pressure, a new PKP had to be performed, the IOL was removed, and an Ahmed valve was implanted (by pars plana vitrectomy). The anterior cap of the same donor cornea was used to perform a tectonic superficial anterior lamellar keratoplasty and the recipient did not have any problem related to fungal infection., CONCLUSIONS: The diagnosis of fungal keratitis should be taken into account once a small infiltrate is seen in the interface of any kind of lamellar keratoplasty. It is not clear whether it is better to treat it conservatively or aggressively.

Notify Library Reference ID4482

Related Incidents