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2015 OMIG Abstract 19

Fungal endophthalmitis after Descemet Stripping Automated Endothelial Keratoplasty due to endogenously infected grafts from the same donor
Sotiria Palioura, Kavitha Sivaraman, Adam Sisse, Juan Batlle, Darlene Miller, Edgar Espana, Guillermo Amescua, Anat Galor, and Carol L. Karp
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami FL

Purpose: To report two cases with post-operative Candida albicans endophthalmitis after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) with grafts originating from the same donor.
Methods: Retrospective case series of two patients with late post-operative fungal endophthalmitis after DSAEK with corneal grafts from the same donor.
Results: Two patients with Fuchs’ dystrophy underwent uncomplicated DSAEK by two corneal surgeons at different surgery centers. Both patients received a cornea from the same donor who had a history of presumed pulmonary candidiasis without positive blood cultures. Both patients were referred to Bascom Palmer Eye Institute with multifocal infiltrates at the graft-cornea interface one month later. Despite immediate explantation of the DSEK lenticules and intraocular antifungal injections both patients progressed to develop fungal endophthalmitis with the same strain of Candida albicans. Following penetrating keratoplasty with intraocular lens explantation, pars plana vitrectomy and serial intraocular antifungal injections, both are doing well at 6 months post-operatively.
Conclusions: Fungal endophthalmitis due to infected donor corneal graft presents a management challenge and should prompt careful follow up of both recipients from the same donor.

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