Donor-to-host transmission of infection: contrasting outcomes of lamellar and penetrating keratoplasty

Donor-to-host transmission of infection is a rare complication of corneal transplantation. Recent evidence reported an increasing trend in the incidence of fungal infection after endothelial keratoplasty compared to penetrating keratoplasty (PK), although neither observation reached statistical significance. The main reason is the creation in lamellar techniques of a donor-host interface that provides a hypoxic sequestered environment for microorganisms to thrive protected from the host immune response. We describe herein the contrasting outcomes of two patients who received tissues from the same donor contaminated with Candida albicans: the first patient underwent Descemet's stripping automated endothelial keratoplasty (DSAEK), while the second one underwent PK.