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Thais Shiota Tanaka, Shahzad Mian; Fungal keratitis after endothelial keratoplasty. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1546.
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To assess outcomes of fungal keratitis after endothelial keratoplasty and literature review.
Adverse Reactions reported to the Midwest Eye Bank were reviewed retrospectively, and cases of fungal keratitis after endothelial keratoplasty were analyzed. A total of ten cases were reported between January 1, 2007 and July 1, 2014. Data regarding adverse reactions characteristics, demographic data from donor and recipient, donor corneal tissue characteristics such as cause of death, death to cooling, preservation and surgery times; donor, recipient and mate tissue cultures and recipient outcomes were collected.
Eight of ten cases were donor-related keratitis. Nine were reported as an infectious keratitis and one as endophthalmitis with nine cases occurring after DSAEK and one after DMEK surgery. Diagnosis of fungal keratitis was made with an average of 66 days after surgery and almost all cases were due to Candida species. Only one recipient had clinical treatment with success. Four recipients underwent PKP, four underwent repeat DSAEK, and one was enucleated. During the follow-up, two recipients had recurrence of infection. One was treated clinically and the other one underwent PKP. None of mate tissue had adverse reaction reported.
Repeat endothelial keratoplasty may provide favorable outcomes and reduce need for PKP especially when performed after an interval of graft removal.
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