Interface Fungal Keratitis After Descemet Stripping Automated Endothelial Keratoplasty: A Review of the Literature With a Focus on Outcomes

Cornea. 2018 Sep;37(9):1204-1211. doi: 10.1097/ICO.0000000000001636.

Abstract

Purpose: To examine the management and associated outcomes of reported cases of interface fungal infection after Descemet stripping automated endothelial keratoplasty (EK).

Methods: A literature review identified reports of interface fungal infection after Descemet stripping automated EK. Data retrieved from the same included patient demographics, surgical procedure undertaken, donor rim culture result, clinical course, and outcome. A review of the relevant literature was also conducted.

Results: Twenty-four cases of interface fungal infection after Descemet stripping automated EK were analyzed. Mean age of those affected was 66 years with range 52 to 85 years. Interface fungal infection after Descemet stripping automated EK was noted at a mean of 49.2 days postoperatively. Candida species were the causative infection in 79% cases. Penetrating keratoplasty was eventually performed in 79% of cases. The mean posttreatment best-corrected visual acuity was 0.44 logMAR.

Conclusions: Penetrating keratoplasty is frequently required to eliminate interface fungal infection after Descemet stripping automated EK. A satisfactory visual outcome is usually achieved.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antifungal Agents / therapeutic use
  • Corneal Stroma / pathology*
  • Corneal Ulcer / diagnosis
  • Corneal Ulcer / etiology*
  • Corneal Ulcer / therapy
  • Descemet Stripping Endothelial Keratoplasty / adverse effects*
  • Eye Infections, Fungal / diagnosis
  • Eye Infections, Fungal / etiology*
  • Eye Infections, Fungal / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures
  • Retrospective Studies

Substances

  • Antifungal Agents