The Role of Corneal Donor Rim Fungal Cultures: Pro Side

Area of Science:

• Ophthalmology
• Microbiology
• Transplantation Science

Background:

• Fungal infections post-corneal transplantation are rare but severe complications.
• The incidence of fungal infections, especially fungal endophthalmitis, has increased.
• Endothelial keratoplasty (EK) and Candida species are disproportionately associated with this trend.

Purpose of the Study:

• To evaluate the significance of universal corneal rim cultures in keratoplasty.
• To assess the correlation between positive fungal rim cultures and postoperative infections.
• To understand the implications for the mate eye and guiding early therapeutic interventions.

Main Methods:

• Review of incidence trends reported by the Eye Bank Association for America.
• Analysis of studies correlating positive corneoscleral donor rim fungal cultures with postoperative infections.
• Examination of the role of rim cultures in diagnosing early-stage fungal keratitis, particularly after EK.

Main Results:

• An increasing trend in post-keratoplasty fungal infections was reported in 2016.
• EK procedures showed a disproportionately higher incidence of fungal endophthalmitis.
• Positive fungal donor rim cultures correlate highly with postoperative infections and pose a risk to the mate eye.

Conclusions:

• Universal corneal rim cultures' value in keratoplasty remains debated.
• Positive fungal rim cultures, especially with interface keratitis post-EK, raise suspicion for fungal etiology.
• Rim cultures can aid in directing early therapy when direct intraocular cultures are difficult.