Ocular
Microbiology and Immunology Group
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2012
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2012
OMIG Abstract 17
Donor-related Candida Interface Keratitis After Descemet Stripping Automated
Endothelial Keratoplasty: a Case Report
B.T. Bryan1, R.H. Rosa1, S.F.A. Fulcher1,2
1Department of Ophthalmology, Scott & White Eye Institute, Temple, TX;
2Division of Ophthalmology, Department of Surgery, Central Texas Veterans’ Health Care System, Temple, TX
Purpose: To report a case of donor-to-host transmission of Candida tropicalis infection at the graft-host interface following Descemet stripping automated endothelial keratoplasty (DSAEK) and to provide recommendations on management.
Methods: A 56-year-old male with advanced Fuchs’ dystrophy underwent combined phacoemulsification and DSAEK and developed an infiltrate at the graft-host interface 5 weeks post-operatively.
Results: Cultures of the donor corneoscleral rim grew pan-sensitive Candida tropicalis, and systemic antifungal prophylaxis was initiated promptly. The patient’s keratitis developed and progressed despite aggressive topical, systemic, and intraocular antifungal agents. Penetrating keratoplasty (PKP) was performed and successfully eradicated the patient’s fungal infection.
Conclusion: PKP is a viable management option following fungal interface keratitis in the setting of prior DSAEK and may lead to a good visual outcome. Medical management alone may not eradicate the organism due to entrapment at the graft-host interface, and surgery may be required.
Disclosure: N
2012
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