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Candidal endophthalmitis after keratoplasty.
A Merchant1, C M Zacks, K Wilhelmus
1The Aga Khan University Hospital, Karachi, Pakistan.
Cornea
|March 15, 2001
Summary
Donor corneas can transmit fungal infections like Candida endophthalmitis after penetrating keratoplasty. This review highlights the poor outcomes and suggests antifungal supplementation of preservation media to prevent transmission.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Penetrating keratoplasty is a common procedure for corneal blindness.
- Fungal endophthalmitis is a rare but serious complication following corneal transplantation.
- Donor-to-host transmission of fungal pathogens poses a significant risk.
Observation:
- A case of explosive Candida endophthalmitis occurred two days post-keratoplasty.
- Candida was identified in the donor corneoscleral rim and recipient's aqueous humor.
- Most donor corneas were preserved in standard cold storage media.
Findings:
- Review of 44 cases revealed 91% had Candida cultured from donor rim or medium.
- Sixty percent of cases with available outcomes had visual acuity of 20/200 or worse.
- Poor visual outcomes were common despite aggressive treatment.
Implications:
- Donor-to-host transmission of fungal endophthalmitis is confirmed.
- Antifungal supplementation of corneal preservation media is recommended.
- Preventative strategies are crucial to improve outcomes in post-keratoplasty fungal endophthalmitis.