EW
CORNEA
35
Examples of fungal keratitis
Source: Francis S. Mah, M.D.
performed on 22 of these and 16 of
the 22 were positive for fungus," Dr.
Aldave said. One was not trans-
planted. However, recipients who re-
ceived 10 of the 15 mates that were
culture positive developed an infec-
tion. "We see a high concordance
between the mate and fungal infec-
tion; the fact that three-fourths of
them are also culture positive shows
that it's coming from the donor," he
said.
Dr. Glasser sees this as highlight-
ing the importance of not only com-
municating with the eye bank if an
infection occurs but also making sure
that this is reported to the surgeon
who used the mate cornea. He
stressed that if you have a positive
rim culture you should be watching
the patient more closely and give se-
rious consideration to starting him or
her
on antifungals. "It also tells us
that the process of obtaining intraop-
erative donor rim cultures, which has
fallen by the wayside in many areas,
should be reconsidered," he said.
FDA reporting system
In another presentation, Samuel B.
Barone, M.D., medical officer,
Office of Cellular, Tissue and Gene
Therapies, Center for Biologics Eval-
uation Research, Rockville, Md., pre-
sented the FDA's perspective on
adverse reactions reported to it. One
concern is that the eye banks might
be introducing the fungal infections.
However, Dr. Barone could find no
definitive evidence on this.
continued on page 36
September 2011
