Fungal endophthalmitis following penetrating keratoplasty

Background: We report a case of fungal endophthalmitis following penetrating keratoplasty (PKP). Case Report: A 45-year-old male had bullous keratopathy in his left eye. He had a history of graft rejection after PKP combined with intraocular lens (IOL) implantation for traumatic corneal opacity. We performed PKP but the eye developed endophthalmitis with white plaques on the IOL and the posterior surface of the cornea 13 days after surgery. Candida albicans was isolated from the donor rim and storage media. Because fungus contaminating a donor cornea is likely to be the cause of endophthalmitis, treatment with topical and systemic antifungal agents was started but was ineffective. Vitrectomy was performed, but the infection could not be controlled and the patient underwent enucleation. Conclusions: Donor rim culture is helpful in the diagnosis and determination of specific treatment for postoperative endophthalmitis, although treatment was not successful in this case. Close collaboration between eye banks and surgeons is necessary for safe performance of PKP.