The Investigation Process Following a Cluster of Post Descemet Stripping Automated Endothelial-Keratoplasty (DSAEK) Endophthalmitis at a Single Eye Bank in Pre-prepared Corneal Tissue

Authors

Con Petsoglou, Gerard Sutton, Jane Treloggan, Raj Devasayaham, Pierre Georges, Nick Toalster, Chris Hodge

Keywords

cornea; donation; Eye Bank; endophthalmitis

Abstract

Purpose: To describe a cluster of endophthalmitis cases following Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) procedures using pre-cut corneal donor tissue from a single eye bank across a four-month period.
Methods: case series and procedural review
Results: 5 eyes of 5 patients were diagnosed with endophthalmitis between 1 day and 2 weeks following DSAEK surgery. Candida parapsilosis was identified as the causative organism in all cases. Microbiological investigation revealed 3 cases (inclusive of 2 eyes from the same donor) exhibited an identical strain indicating probable contamination. Contamination of the microkeratome head was considered the probable reason however the true source could not be confirmed. Two further cases were diagnosed as non-identical strains suggesting additional sources.
Conclusion: The appearance of a cluster requires immediate attention to identify potential sources and minimise further risk. Review of the preparation process is discussed.