ENDOPHTHALMITIS CLUSTER FROM CONTAMINATED DONOR CORNEAS FOLLOWING PENETRATING KERATOPLASTY

Objective: To attempt to identify common events or factors in four cas es of endophthalmitis that developed after penetrating keratoplasty pe rformed within a 1-week interval. Design: Case series. Setting: Tertia ry care eye hospital in Riyadh, Saudi Arabia. Patients: Four patients in whom endophthalmitis developed after penetrating keratoplasty perfo rmed in May 1993. Outcome measures: Source of donor tissue, transporta tion of corneas, handling of corneas at the eye hospital, and causativ e organism and sensitivity profile. Results: The donor tissue in all f our cases originated from the same eye bank. Organisms were cultured f rom 10 of the 11 donor rims from eye bank A tissue used during the wee k in question. The causative organisms were Enterococcus faecalis in t hree patients and Torulopsis glabrata in one patient. In each case the same organism was cultured from the recipient eye and the correspondi ng donor rim. Two of the four patients had a favourable outcome. Concl usions: Donor rim culture is essential if the cause of endophthalmitis after penetrating keratoplasty is to be determined, Close communicati on between eye bank personnel, the microbiology laboratory and the ope rating surgeon is important as it may influence early detection, choic e of treatment and outcome of endophthalmitis after penetrating kerato plasty, Epidemiologic studies from both the source eye bank and the re cipient facility are required to fully investigate the cause of a clus ter of endophthalmitis cases from contaminated donor tissue following penetrating keratoplasty.