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Case Reports
. 2020 Apr 17:18:100707.
doi: 10.1016/j.ajoc.2020.100707. eCollection 2020 Jun.

Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture

Kenneth A Beckman  1   2 , Mark S Milner  3   4 , Parag A Majmudar  5 , Jodi I Luchs  6   7
Affiliations
Case Reports

Late-onset fungal interface keratitis following endothelial keratoplasty with positive donor fungal culture

Kenneth A Beckman et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: To describe late-onset fungal keratitis after Descemet's stripping endothelial keratoplasty (DSEK) with positive fungal culture of the donor corneal rim.

Observations: A case report of a patient undergoing DSEK is described whereby the donor corneal rim culture grew fungus. No infection was initially noted, but the patient developed fungal keratitis 1 year after the original DSEK procedure, despite prophylactic treatment at the time of the positive donor culture. The patient responded to antifungal therapy, but fungal keratitis recurred following completion of a 1-year course of antifungal treatment. The patient eventually underwent full thickness keratoplasty.

Conclusions and importance: A positive fungal culture of the donor rim tissue at the time of endothelial keratoplasty is a risk factor for fungal keratitis. Even with prophylactic antifungal treatment, fungal keratitis may eventually develop as late as 1 year after the initial endothelial keratoplasty procedure. Treatment may need to be aggressive, but keratitis may recur despite resolution with antifungal treatment.

Keywords: Donor contamination; Donor culture; Endothelial keratoplasty; Fungal keratitis.

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Conflict of interest statement

The following authors have no financial disclosures: KB, MM, PM, JL.

Figures

Fig. 1
Fig. 1
Infiltrate in graft interface adjacent to pupil margin.
Fig. 2
Fig. 2
OCT image of cornea demonstrating interface infiltrate.
See this image and copyright information in PMC

References

    1. Boynton G.E., Woodward M.A. Evolving techniques in corneal transplantation. Curr Surg Rep. 2015;3(2) - PMC - PubMed
    1. McElnea E., Power B., Murphy C. Interface fungal keratitis after descemet stripping automated endothelial keratoplasty: a review of the literature with a focus on outcomes. Cornea. 2018;37(9):1204–1211. - PubMed
    1. Eye Bank Association of America . Eye Bank Association of America; Washington, DC: 2016. Eye Banking Statistical Report; p. 2016.
    1. Tsui E., Fogel E., Hansen K. Candida interface infections after descemet stripping automated endothelial keratoplasty. Cornea. 2016;35(4):456–464. - PubMed
    1. Wessel J.M., Bachmann B.O., Meiller R., Kruse F.E. Fungal interface keratitis by Candida orthopsilosis following deep anterior lamellar keratoplasty. BMJ Case Rep. 2013;2013 - PMC - PubMed

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