chondroitin-sulfates and Mycoses

This retrospective study of 549 corneo-scleral rim cultures shows that gentamicin, used in MK and K-Sol medium storage at 4 degrees C, has decreased donor contamination from 43% in whole-globe storage to 13%, but failed to eliminate coagulase negative staphylococci (37%), streptococci (28%) and fungi (28%). 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 degrees 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 degrees C storage. In the absence of ideal antimicrobial cover for corneal preservation solutions, stringent prophylactic measures to reduce contamination and continued monitoring of corneo-scleral rim cultures are warranted, if the poor visual consequences of donor-to-host transmitted endophthalmitis are to be avoided.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Candidiasis; Child; Child, Preschool; Chondroitin Sulfates; Corneal Transplantation; Endophthalmitis; Gentamicins; HEPES; Humans; Infant; Infant, Newborn; Male; Middle Aged; Mycoses; Organ Preservation; Postoperative Complications; Retrospective Studies; Staphylococcal Infections; Streptococcal Infections