Severe donor-related Candida keratitis after Descemet’s stripping automated endothelial keratoplasty

Infectious keratitis after keratoplasty

“…They further found patients with a persistent epithelial defect to ]. Although transfer of bacterial pathogens from donor to host is thought to be a rare cause of infectious keratitis, positive fungal rim cultures are more commonly found in association with subsequent fungal keratitis [40,41]. Risk factors for fungal contamination of donor corneal tissue include time from donor's death to preservation of tissue greater than 12 h [40,42,43] and death because of cardiac disease [39].…”

Candida Interface Infections After Descemet Stripping Automated Endothelial Keratoplasty

“…12 Of the 13 cases for which donor rim cultures were obtained, 61.5% (8/13) were positive for Candida spp. 5,6,8,10,13,14,16 The cultures in the remaining 5 cases for which donor rim cultures were obtained remained negative. 7,8,11,12 The median time to clinical infection was postoperative day 36 (range 1-1000 days).…”

“…4 Published reports have also documented fungal interface keratitis and endophthalmitis following Descemet stripping automated endothelial keratoplasty (DSAEK). [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] We describe our experience of Candida spp DSAEK interface infections associated with positive donor rim cultures, the ensuing investigation, and a review of the current literature. These cases highlight important considerations regarding eye bank and surgical practices.…”

Current Concepts in the Management of Unique Post-keratoplasty Infections

“…When looking at only interface keratitis, fungal infection is much more common. Reported fungal interface keratitis cases after EK were all caused by Candida species[16-20]. Much like after DALK, white or cream-colored interface infiltrates, either solitary[20] or multiple[16, 18] are described.…”

“…Reported fungal interface keratitis cases after EK were all caused by Candida species[16-20]. Much like after DALK, white or cream-colored interface infiltrates, either solitary[20] or multiple[16, 18] are described. Because of the difficulty of obtaining a culture from the interface, the interface infections were diagnosed either after anterior chamber tap or explant of the donor lenticule.…”