Incidence and outcome of transplantation of fungal-culture-positive donor corneoscleral tissue in optical keratoplasty
- PDF / 238,267 Bytes
- 7 Pages / 547.087 x 737.008 pts Page_size
- 22 Downloads / 179 Views
(0123456789().,-volV) ( 01234567 89().,-volV)
ORIGINAL PAPER
Incidence and outcome of transplantation of fungal-culturepositive donor corneoscleral tissue in optical keratoplasty Rawan Saleh Alshabeeb . Ahmed Abdullah Aldayel . Hernan Martinez-Osorio . Muhammad Ali Ahad
Received: 4 July 2020 / Accepted: 29 October 2020 Ó Springer Nature B.V. 2020
Abstract Purpose This study aims to determine the incidence of fungal-culture-positive corneoscleral donor rim in patients undergoing keratoplasty and evaluate clinical outcomes of eyes that received these contaminated donor tissues. Methods Patients who had optical keratoplasty between 2006 and 2016 and were found to have fungal-culture-positive donor rim were included. Microbiological and eye bank records were reviewed to determine the incidence of positive fungal rim cultures. Data were collected on visual and clinical outcomes. The main outcome measures were fungalculture-positive donor rim and development of fungal keratitis or endophthalmitis post keratoplasty. Longterm clinical outcome and associated complications were the secondary outcome measures. Results Out of 9620 cases of corneal transplants, 145 (1.5%) had fungal-culture-positive donor rim. Candida was the most common organism, cultured in 127 (87.6%) cases. There were no cases of postoperative fungal keratitis or endophthalmitis. Median follow-up was 4.8 years (interquartile range 3.8–7.2 years).
R. S. Alshabeeb A. A. Aldayel H. Martinez-Osorio M. A. Ahad (&) Anterior Segment Division, King Khalid Eye Specialist Hospital, Al Oruba Road, P.O. Box 7191, Riyadh 11462, Saudi Arabia e-mail: [email protected]; [email protected]
Only eight cases (5.5%) received prophylactic antifungal treatment. There were 34 (23.4%) cases of rejection, 13 (8.9%) developed glaucoma, and 7 (4.8%) developed late bacterial keratitis. At last follow-up, best corrected visual acuity was 20/60 or better in 88 cases (60.7%) and 115 eyes (79.3%) had a clear graft. Conclusion The incidence of fungal-culture-positive donor rim is extremely low. The risk of developing fungal keratitis or endophthalmitis in patients who received contaminated donor tissue was almost negligible. Further studies are warranted to prove whether prophylaxis or adding amphotericin B in Optisol-GS confers any added benefit. Keywords Keratoplasty Fungal Endophthalmitis Keratitis
Introduction Corneal transplantation is a widely accepted surgical intervention for the treatment of various corneal disorders and prevention of blindness. Infectious keratitis and endophthalmitis post corneal transplantation are rare but lead to devastating complications [1]. The introduction of gentamicin and streptomycin in Optisol (Optisol- GS; Bausch and Lomb, Rochester, NY, USA) in the early 1990s decreased the incidence
123
Int Ophthalmol
of bacterial keratitis and endophthalmitis after keratoplasty. With no added antifungals in this preservation medium, the relative risk of fungal keratitis is more than three times that of bacterial keratitis for corneas p
Data Loading...
