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Updated: Nov 18, 2025
Murine Corneal Transplantation: A Model to Study the Most Common Form of Solid Organ Transplantation
Published on: November 17, 2014
Incidence of Fungal Infection in Positive Donor Rim Cultures after Corneal Transplantation
Julia Shatten1, Roheena Kamyar1,2, Deepinder Dhaliwal1,2
1Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Purpose:
To determine the clinical outcomes of corneal transplant patients that had positive rim cultures for fungi.
Methods:
Retrospective study.
Results:
Of 1276 rim cultures obtained between 2009 and 2019, 16 were positive for fungus (incidence of 1.25%). Clinical data were available for 12 patients. Candida and Cladosporium species were the most common organisms. Recipient ages ranged from 51 to 86 (median age 69 years; 9 males, 7 females). The most common surgery was Endothelial Keratoplasty (n = 8). There were no instances of fungal keratitis or endophthalmitis. Three patients were treated with prophylactic antimycotics. One patient developed bacterial keratitis. One patient had a varicella zoster virus reactivation without corneal involvement.
Conclusions:
This study adds to the growing data on the low rate of fungal keratitis and endophthalmitis after a corneal transplant, even in the case of positive rim cultures. This study also suggests that positive rim cultures do not advance the risk of postoperative fungal infection in the recipient.
Insights
Positive fungal rim cultures after corneal transplants are rare and do not increase the risk of fungal keratitis or endophthalmitis. This finding offers reassurance for transplant recipients and surgeons regarding fungal infection risks.
Area of Science:
- Ophthalmology
- Microbiology
- Transplantation
Background:
- Corneal transplantation is a common procedure to restore vision.
- Positive rim cultures in corneal transplants can raise concerns about potential infections.
- Fungal infections post-transplant require careful monitoring and management.
Purpose of the Study:
- To evaluate the clinical outcomes of corneal transplant recipients with positive fungal rim cultures.
- To determine the incidence of fungal keratitis and endophthalmitis in these cases.
- To assess the risk associated with positive fungal rim cultures.
Main Methods:
- Retrospective analysis of corneal rim cultures from 2009-2019.
- Identification of fungal species from positive cultures.
- Review of clinical data for patients with positive fungal rim cultures.
Main Results:
- 16 out of 1276 rim cultures (1.25%) were positive for fungi.
- Common fungi included Candida and Cladosporium species.
- No cases of fungal keratitis or endophthalmitis were observed in the studied patients.
Conclusions:
- Positive fungal rim cultures after corneal transplantation are associated with a low incidence of subsequent fungal keratitis or endophthalmitis.
- The presence of fungi in rim cultures does not appear to elevate the risk of postoperative fungal infections.
- These findings suggest a generally favorable prognosis even with positive fungal cultures.
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