TY - JOUR
T1 - Report of the eye bank association of America medical advisory board subcommittee on fungal infection after corneal transplantation
AU - Aldave, Anthony J.
AU - Dematteo, Jennifer
AU - Glasser, David B.
AU - Tu, Elmer Y.
AU - Iliakis, Bernardino
AU - Nordlund, Michael L.
AU - Misko, Jachin
AU - Verdier, David D.
AU - Yu, Fei
PY - 2013/2/1
Y1 - 2013/2/1
N2 - PURPOSE:: To investigate the incidence of fungal infections after corneal transplantation to determine whether storage media supplementation with an antifungal should be considered. METHODS:: Adverse reactions reported to the Eye Bank Association of America through the online adverse reaction reporting system between January 1, 2007, and December 31, 2010, were reviewed to identify cases of recipient fungal infection. Data were collected regarding the donor, the donor cornea, recovery and processing, and mate culture and clinical course of the recipients. RESULTS:: Thirty-one cases of culture-proven fungal keratitis (n = 14) and endophthalmitis (n = 17) were reported out of 221,664 corneal transplants performed using corneal tissue distributed by domestic eye banks (1.4 cases per 10,000 transplants performed). Although the annual incidence of postkeratoplasty fungal infection has not increased significantly since 2005, a trend toward an increasing rate of fungal infection has been observed. Fungal infections were more commonly reported after endothelial keratoplasty procedures (0.022%) than penetrating keratoplasty procedures (0.012%), but the difference was not statistically significant (P = 0.076). Additionally, no association was found between fungal infection after endothelial keratoplasty and whether the lamellar tissue cut was performed by the surgeon or the eye bank technician. Seventy-three percent (16 of 22) of the fungal cultures performed on the mate corneas were positive, with infection developing in 67% (10 of 15) of recipient eyes (endophthalmitis in 6 eyes and keratitis in 4 eyes). CONCLUSIONS:: Although a nonsignificant increasing trend in the rate of fungal infection has been observed over the past 6 years, it is not sufficiently compelling to pursue antifungal supplementation of donor storage media.
AB - PURPOSE:: To investigate the incidence of fungal infections after corneal transplantation to determine whether storage media supplementation with an antifungal should be considered. METHODS:: Adverse reactions reported to the Eye Bank Association of America through the online adverse reaction reporting system between January 1, 2007, and December 31, 2010, were reviewed to identify cases of recipient fungal infection. Data were collected regarding the donor, the donor cornea, recovery and processing, and mate culture and clinical course of the recipients. RESULTS:: Thirty-one cases of culture-proven fungal keratitis (n = 14) and endophthalmitis (n = 17) were reported out of 221,664 corneal transplants performed using corneal tissue distributed by domestic eye banks (1.4 cases per 10,000 transplants performed). Although the annual incidence of postkeratoplasty fungal infection has not increased significantly since 2005, a trend toward an increasing rate of fungal infection has been observed. Fungal infections were more commonly reported after endothelial keratoplasty procedures (0.022%) than penetrating keratoplasty procedures (0.012%), but the difference was not statistically significant (P = 0.076). Additionally, no association was found between fungal infection after endothelial keratoplasty and whether the lamellar tissue cut was performed by the surgeon or the eye bank technician. Seventy-three percent (16 of 22) of the fungal cultures performed on the mate corneas were positive, with infection developing in 67% (10 of 15) of recipient eyes (endophthalmitis in 6 eyes and keratitis in 4 eyes). CONCLUSIONS:: Although a nonsignificant increasing trend in the rate of fungal infection has been observed over the past 6 years, it is not sufficiently compelling to pursue antifungal supplementation of donor storage media.
KW - eye banking
KW - fungal endophthalmitis
KW - fungal keratitis
KW - keratoplasty
UR - http://www.scopus.com/inward/record.url?scp=84872923553&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84872923553&partnerID=8YFLogxK
U2 - 10.1097/ICO.0b013e31825e83bf
DO - 10.1097/ICO.0b013e31825e83bf
M3 - Article
C2 - 23051906
AN - SCOPUS:84872923553
SN - 0277-3740
VL - 32
SP - 149
EP - 154
JO - Cornea
JF - Cornea
IS - 2
ER -