Donor-related Candida keratitis after Descemet stripping automated endothelial keratoplasty

Anna S Kitzmann; Michael D Wagoner; Nasreen A Syed; Kenneth M Goins

doi:10.1097/ICO.0b013e31819140c4

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Donor-related Candida keratitis after Descemet stripping automated endothelial keratoplasty

Journal article

Peer reviewed

Donor-related Candida keratitis after Descemet stripping automated endothelial keratoplasty

Anna S Kitzmann, Michael D Wagoner, Nasreen A Syed and Kenneth M Goins

Cornea, Vol.28(7), pp.825-828

08/2009

DOI: 10.1097/ICO.0b013e31819140c4

PMID: 19574899

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Abstract

To report 2 cases of donor-to-host transmission of Candida albicans interface keratitis after Descemet stripping automated endothelial keratoplasty (DSAEK). We performed clinical and microbiologic examinations on 2 patients who underwent DSAEK for pseudophakic corneal edema. Two patients underwent uneventful DSAEK surgery using corneal tissue from the same donor. The donor corneoscleral rims were cultured at the time of surgery and both rims subsequently grew C. albicans and Candida glabrata. Approximately 5 weeks after surgery, infiltrates were noted in the DSAEK interface in both of these patients. Despite treatment with antifungal therapy, the Candida keratitis was unable to be controlled medically and required surgical intervention in each case, after which there was no recurrence of infection. Candida interface keratitis can occur after DSAEK. These 2 cases emphasize the importance of donor corneoscleral rim cultures, especially with the increase in lamellar and endothelial keratoplasty, which can make such interface infections more difficult to diagnose and treat. Patients with fungal positive donor corneal rim cultures should be prophylactically treated with antifungal therapy.

Cornea - microbiology

Descemet Membrane - surgery

Candidiasis - transmission

Eye Infections, Fungal - surgery

Fuchs' Endothelial Dystrophy - surgery

Humans

Endothelium, Corneal - transplantation

Candidiasis - microbiology

Candidiasis - surgery

Corneal Ulcer - surgery

Eye Infections, Fungal - microbiology

Corneal Transplantation - adverse effects

Candida albicans - isolation & purification

Aged, 80 and over

Corneal Ulcer - microbiology

Female

Disease Transmission, Infectious

Tissue Donors

Eye Infections, Fungal - transmission

Details

Title: Subtitle: Donor-related Candida keratitis after Descemet stripping automated endothelial keratoplasty
Creators: Anna S Kitzmann - Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
Michael D Wagoner
Nasreen A Syed
Kenneth M Goins
Resource Type: Journal article
Publication Details: Cornea, Vol.28(7), pp.825-828
Publisher: United States
DOI: 10.1097/ICO.0b013e31819140c4
PMID: 19574899
ISSN: 0277-3740
eISSN: 1536-4798
Language: English
Date published: 08/2009
Academic Unit: Pathology; Ophthalmology and Visual Sciences
Record Identifier: 9983979973902771

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