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To determine the clinical outcomes of corneal transplant patients that had positive rim cultures for fungi. Retrospective study. Of 1276 rim cultures obtained between 2009 and 2019, 16 were positive for fungus (incidence of 1.25%). Clinical data were available for 12 patients.  Candida  and  Cladosporiumspecies  were the most common organisms. Recipient ages ranged from 51 to 86 (median age 69 years; 9 males, 7 females). The most common surgery was Endothelial Keratoplasty (n = 8). There were no instances of fungal keratitis or endophthalmitis. Three patients were treated with prophylactic antimycotics. One patient developed bacterial keratitis. One patient had a varicella zoster virus reactivation without corneal involvement. This study adds to the growing data on the low rate of fungal keratitis and endophthalmitis after a corneal transplant, even in the case of positive rim cultures. This study also suggests that positive rim cultures do not advance the risk of postoperative fungal infection in the recipient.

Incidence of Fungal Infection in Positive Donor Rim Cultures after Corneal Transplantation