Candida albicans interface infection after deep anterior lamellar keratoplasty.
OBJECTIVE
To report a case of interface infection by Candida albicans after deep anterior lamellar keratoplasty (DALK).


METHODS
A 30-year-old man with keratoconus underwent DALK. Four weeks after surgery, the patient developed multiple infiltrates in the graft-host interface with absence of intraocular infection. Donor rim cultures grew C. albicans. Penetrating keratoplasty (PK) was performed because of worsening of the infection despite topical, local, and systemic antifungal therapy.


RESULTS
Cultures carried out on the excised donor cornea confirmed donor-to-host transmission of C. albicans. An aqueous tap taken before PK was negative. Six months after PK, the corneal graft was clear with no recurrence of infection.


CONCLUSIONS
After DALK, in cases of donor graft microbial contamination, infection may develop at the graft-host interface. This may delay or prevent direct intraocular penetration of microorganisms, reducing the risk of development of endophthalmitis. PK may be needed to eradicate the infection in cases where conservative treatment fails.
Unità Operativa di Oculistica, Ospedale Maggiore, Bologna, Italy. luigi.fontana@ausl.bologna.it
Luigi
L
Fontana
Gabriella
G
Parente
Bruna
B
Di Pede
Giorgio
G
Tassinari
D000328:Adult; D002177:Candidiasis / Q000601:surgery / Q000635:transmission*; D003316:Corneal Diseases / Q000209:etiology* / Q000601:surgery; D016039:Corneal Transplantation / Q000009:adverse effects*; D018562:Disease Transmission, Infectious; D004728:Endothelium, Corneal / Q000637:transplantation*; D015821:Eye Infections, Fungal / Q000601:surgery / Q000635:transmission*; D006801:Humans; D007640:Keratoconus / Q000601:surgery; D015948:Keratoplasty, Penetrating; D008297:Male; D014019:Tissue Donors