Corneo-scleral rim cultures: Donor contamination a case of fungal endophthalmitis transmitted by K-Sol stored cornea

Abstract

This retrospective study of 549 corneo-sclerai rim cultures shows that gentamicin, used in MK and K-Sol medium storage at 4°C, has decreased donor contamination from 43%; in whole- globe storage to 13#x0025;, but failed to eliminate coagulase negative staphylococci (37#x0025;), streptococci (28#x0025;) and fungi (28#x0025;). Donor-to-host transmitted staphylococcal and streptococcal endophthalmitis have been reported previously. We present the first documented case of donor-to-recipient transmitted fungal endophthalmitis following corneal transplantation using corneas stored in MK or K-Sol solution at 4°C; Candida albicans was isolated. Recommendations are made to assess critically the true incidence of donor fungal contamination and the necessity of adding anti-mycotic agents to preservation medium for 4°C storage. In the absence of ideal antimicrobial cover for corneal preservation solutions, stringent prophylactic measures to reduce contamination and continued monitoring of corneo-sclerai rim cultures are warranted, if the poor visual consequences of donor-to-host transmitted endophthalmitis are to be avoided. © 1988, College of Ophthalmologists. All right reserved.