Endophthalmitis cluster from contaminated donor corneas following penetrating keratoplasty.
OBJECTIVE
To attempt to identify common events or factors in four cases of endophthalmitis that developed after penetrating keratoplasty performed within a 1-week interval.


METHODS
Case series.


METHODS
Tertiary care eye hospital in Riyadh, Saudi Arabia.


METHODS
Four patients in whom endophthalmitis developed after penetrating keratoplasty performed in May 1993.


METHODS
Source of donor tissue, transportation of corneas, handling of corneas at the eye hospital, and causative organism and sensitivity profile.


RESULTS
The donor tissue in all four cases originated from the same eye bank. Organisms were cultured from 10 of the 11 donor rims from eye bank A tissue used during the week in question. The causative organisms were Enterococcus faecalis in three patients and Torulopsis glabrata in one patient. In each case the same organism was cultured from the recipient eye and the corresponding donor rim. Two of the four patients had a favourable outcome.


CONCLUSIONS
Donor rim culture is essential if the cause of endophthalmitis after penetrating keratoplasty is to be determined. Close communication between eye bank personnel, the microbiology laboratory and the operating surgeon is important as it may influence early detection, choice of treatment and outcome of endophthalmitis after penetrating keratoplasty. Epidemiologic studies from both the source eye bank and the recipient facility are required to fully investigate the cause of a cluster of endophthalmitis cases from contaminated donor tissue following penetrating keratoplasty.
Cameron
J A
JA
Badr
I A
IA
Miguel Risco
J
J
Abboud
E
E
Gonnah el-S
D000328:Adult; D000900:Anti-Bacterial Agents; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D016000:Cluster Analysis; D003315:Cornea / Q000382:microbiology; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D013293:Enterococcus faecalis / Q000302:isolation & purification; D005125:Eye Banks; D015817:Eye Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors
D000900:Anti-Bacterial Agents