Donor-related Candida keratitis after Descemet stripping automated endothelial keratoplasty

TitleDonor-related Candida keratitis after Descemet stripping automated endothelial keratoplasty
Publication TypeJournal Article
Year of Publication2009
AuthorsKitzmann AS, Wagoner MD, Syed NA, Goins KM
Pagination825 - 8
Date PublishedAug
ISSN1536-4798 (Electronic) 0277-3740 (Linking)
Accession Number19574899
Keywords*Disease Transmission, Infectious, Aged, 80 and over, Candida albicans / isolation & purification, Candidiasis / microbiology / surgery / *transmission, Cornea / microbiology, Corneal Transplantation / *adverse effects, Corneal Ulcer / *microbiology / surgery, Descemet Membrane / *surgery, Endothelium, Corneal / *transplantation, Eye Infections, Fungal / microbiology / surgery / *transmission, Female, Fuchs' Endothelial Dystrophy / surgery, Humans, Tissue Donors

PURPOSE: To report 2 cases of donor-to-host transmission of Candida albicans interface keratitis after Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS: We performed clinical and microbiologic examinations on 2 patients who underwent DSAEK for pseudophakic corneal edema. RESULTS: Two patients underwent uneventful DSAEK surgery using corneal tissue from the same donor. The donor corneoscleral rims were cultured at the time of surgery and both rims subsequently grew C. albicans and Candida glabrata. Approximately 5 weeks after surgery, infiltrates were noted in the DSAEK interface in both of these patients. Despite treatment with antifungal therapy, the Candida keratitis was unable to be controlled medically and required surgical intervention in each case, after which there was no recurrence of infection. CONCLUSIONS: Candida interface keratitis can occur after DSAEK. These 2 cases emphasize the importance of donor corneoscleral rim cultures, especially with the increase in lamellar and endothelial keratoplasty, which can make such interface infections more difficult to diagnose and treat. Patients with fungal positive donor corneal rim cultures should be prophylactically treated with antifungal therapy.

URLinternal-pdf://Kitzmann - Donor_Related_Candida_Keratitis-2006988288/Kitzmann - Donor_Related_Candida_Keratitis.pdf
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