Literature review of clinical cases and case series of interface keratitisfollowing DSAEK and DMEK
| Patients (n) | Age (years) | Type of surgery | Donor preparation | Microorganism isolated from specimens | Time to infection onset (days) | Donor rim culture | Time to positive donor rim culture report (days) | Medical treatment topical and /or systemic | Surgical treatment | Endophtha lmitis | Visual outcome (BSCVA Snellen) | Postoperative complications | |
| Koenig et al
16 | 1 | 80 | DSAEK | Uncut |
Candida albicans
(donor lenticule) | 7 | C. albicans | 5 | None | Donor lenticule removal then PK | No | NPL | Phtisis bulbi Enucleation |
| Kitzmann et al 17 | 2 | 80 | DSAEK | nr |
C
.
albicans
(aqueous tap) | 39 |
C
.
albicans, Candida glabrata, Streptoco ccus | 3 | Topical amphotericin B 0.15% Oral fluconazole 200 mg two times a day | Donor lenticule exchange+intracameral amphotericin B (5 µg/0.1mL) | No | 20/50 | No |
| 80 | DSAEK | nr |
C
.
albicans
(anterior corneal infiltrate scraping) | 41 |
C
.
albicans, C . glabrata, Streptococcus | 3 | Topical amphotericin B 0.15% Oral fluconazole 200 mg two times a day | Intracameral amphotericin B (5 µg/0.1 mL)×2 Intravitreal amphotericin B (10 µg/0.1 mL) Peripheral patch graft | No | 20/40 | No | ||
| Chew et al 18 | 1 | 72 | DSAEK | Uncut |
C. parapsilosis
(aqueous and vitreous tap) | 2 | Negative | na | Topical amphotericin B (1 mg/mL) Oral voriconazole 200 two times a day | Intravitreal amphotericin B (0.1 mg)×3 PK+vitrectomy | Yes | 20/40 | No |
| Lee et al 19 | 2 | 81 | DSAEK | Precut |
C
.
glabrata
(donor lenticule) | 30 | C . glabrata | 3 | Topical amphotericin B 0.15% Oral voriconazole 100 two times a day | PK+intravitreal amphotericin B (10 µg/0.1 mL) | No | 20/25 | No |
| 76 | DSAEK | Uncut |
C
.
albicans
(corneal scraping) | 21 | Negative | 7 | Topical amphotericin B 0.15% Oral fluconazole 200 mg two times a day | PK | No | NPL | Supra choroidal haemorrhage Phtisis bulbi | ||
| Ortiz-Gomariz et al 20 | 1 | 76 | DSAEK | Uncut |
C. albicans
(donor lenticule, aqueous+vitreous taps) | 90 | Not tested | na | Voriconazole 200 mg two times a day intravenous Topical voriconazole | Donor lenticule removal+vitrectomy PK+trabeculectomy | Yes | 20/200 | No |
| Sharma et al 21 | 1 | 62 | DSAEK | nr |
Aspergillus fumigatus
(donor lenticule) | 30 | Negative | na | Natamycin 5% Voriconazole 200 mg two times a day | PK | No | 20/40 | No |
| Yamazoe et al 22 | 1 | 74 | DSAEK | nr |
C. albicans
(aqueous tap) | 34 | C. albicans | nr | Topical voriconazole 1%+micafungin 0.1% Intravenous voriconazole 200 mg two times a day | Donor lenticule removal+posterior stroma debridement; 4 months later PK+gonioplasty+intraocular lens exchange | No | 20/22 | No |
| Holz et al 23 | 2 | 69 | DSAEK | Precut |
C
.
albicans
(donor lenticule) | 7 | C . albicans | nr | Topical amphotericin B+voriconazole Oral fluconazole 200 mg two times a day | Donor lenticule removal Intracameral amphotericin B (5 mg)+vancomycin (1 mg)+ceftazidime (2.2 mg) PK+glaucoma tube | No | 20/30 | No |
| 54 | DSAEK | Precut |
C
.
albicans
(donor lenticule) | 49 | C . albicans | nr | Topical amphotericin B (2 mg/mL)+voriconazole 1%. Oral fluconazole 200 mg two times a day | Intravitreal amphotericin B (5 µg/0.1 mL)×4 Lenticule removal PK | No | 20/80 (previous RD surgery) | No | ||
| Tu et al 24 | 2 | 66 | DSAEK | nr | Not assessed | 90 | Negative | na | Oral fluconazole 200 mg two times a day | Several intrastromal amphotericin B (5 µg/mL) | No | 20/500 | Corneal oedema |
| 70 | DSAEK | nr | Not assessed | 49 | Negative | na | Oral voriconazole 100 mg BD | Intrastiomal voriconazole (50 mg/mL) weekly for 3 weeks | No | 20/60 | No | ||
| Nahum et al 25 | 7 | 52 | DSAEK for all cases | Uncut for all cases |
Candida
parapsilosis | 112 | Negative for all cases | na for all cases | Same treatment for all patients. Topical fortified antibiotics and antifungals. | 20/20 | No | ||
| 83 |
Staphylococcus
aureus | 56 | 20/100 | No | |||||||||
| 67 | 21 | 20/100 | No | ||||||||||
| 70 |
Candida parapsilosis
(donor lenticule) | 20/200 | No | ||||||||||
| 63 | Nocardia species | 28 | Same procedure for all patients. PK+intracameral amphotericin B, amikacin, vancomycin, ceftazidime | Not for all cases | 20/50 | No | |||||||
| Staphylococcus | |||||||||||||
| 63 |
C
. albicans
(donor lenticule) | No | |||||||||||
| 71 | Staphylococcus | 28 | No | ||||||||||
| 112 | |||||||||||||
| Weng et al 26 | 1 | 80 | DSAEK | nr |
C. glabrata
(donor lenticule and vitreous tap) | 28 | Candida glabrata | 6 | Topical amphotericin B 0.15%, vancomycin (50 mg/mL), tobramycin (14 mg/mL). Oral fluconazole 200 mg once a day | Lenticule removal+pars plana vitrectomy+intravitreal amphotericin B, vancomycin, ceftazidime | Yes | 20/200 | Corneal oedema |
| Hsu et al 27 | 1 | 45 | DSAEK | nr |
C. albicans
(aqueous tap, donor lenticule) | 1 | C . albicans | nr | Topical voriconazole 1% Oral fluconazole 200 mg two times a day | Donor lenticule removal+intravitreal voriconazole 100 µg PK+pars plana vitrectomy Repeat vitrectomy+glaucoma tube | Yes | 20/100 | No |
| Villarubia et al 28 | 1 | 73 | DSAEK | Uncut |
C. albicans
(donor lenticule) | 10 | C . albicans | 10 | Topical voriconazole 1% Oral voriconazole 200 mg once a day | Intracameral voriconazole 0.15 PK+intracameral and intravitreal voriconazole 0.1% Repeat PK+pars plana vitrectomy+glaucoma valve | No | HM | Optic atrophy |
| Tsui et al4 | 2 | 85 | DSAEK | Precut |
C. albicans
(donor lenticule) | 20 | C. albicans | 1 | Topical amphotericin B 0.15% | Multiple intracameral amphotericin B 5 µg/0.1 mL | No | 20/40 | No |
| 75 | Precut |
C. albicans
(donor lenticule) | 20 | C. glabrata | 1 | Oral fluconazole 200 mg once a day | Donor lenticule exchange PK | No | 20/40 | No | |||
| Wilde et al 29 | 1 | 57 | DSAEK | Uncut | Scopulariopsis gracilis species | 2 | S. gracilis species | 2 | Topical amphotericin B 0.15% Topical voriconazole 1% Oral voriconazole 200 mg two times a day | Donor lenticule removal+multiple amphotericin B 5 µg/0.1 mL PK | No | 20/40 | No |
| Thompson et al 30 | 1 | 75 | DMEK | Prestripped |
C. glabrata
(donor lenticule) | 8 | C. albicans | 2 | Topical voriconazole 1% Oral voriconazole 100 mg two times a day | Intracameral and intravitreal voriconazole 100 µg Donor lenticule removal DSAEK | No | 20/60 | No |
| Tu et al 31 | 1 | 61 | DMEK | nr | Not assessed | 30 | C. glabrata | 14 | Oral fluconazole 200 mg two times a day | Two intrastromal amphotericin B 5 µg/0.1 mL | No | 20/25 | No |
| Porteret al 32 | 1 | 68 | DSAEK | nr | Enterococcus faecalis | 120 | Not tested | na | Topical moxifloxacin 1% | PK Pars plana vitrectomy | Yes | 20/50 | No |
| Palioura et al 33 | 2 | 81 | DSAEK | Precut |
C. albicans
(aqueous tap donor lenticule) | 28 | C. albicans | 7 | Topical amphotericin B (5) mg/mL+ | Intracameral and | No | 20/30 | No |
| 67 | DSAEK | Precut |
C. albicans
(aqueous tap) | 42 | Negative | na | Voriconazole (10 mg/mL | No | 20/20 | No | |||
BSCVA, best spectacle corrected visual acuity; DSAEK, Descemet stripping automated endothelial keratoplasty; DMEK, Descemet membrane endothelial keratoplasty; PK, penetrating keratoplasty; HM, hand movement; NPL, no perception of light; RD, retinal detachment; na, not applicable; nr, not reported.