Clinical characteristics, management and outcomes of patients with Recurrence after therapeutic PK (Refer to Table 2)

Case no.	Age/gender	Site of initial recurrence	Time interval between Th PK and recurrence	Donor graft size (mm)	Clinical Course on medical therapy (natamycin 1 h and oral Azoles)	Surgical intervention for recurrence	Microbiology characteristics (smear+/- culture)	Final outcome
1	46/m	GHJ	27 days	9.5	Resolved on medical therapy	Nil	Fungus filaments	Anatomical restoration, BCVA -20/200 at 4 months
2	36/m	GHJ	7 days	12	Rapid spread to posterior segment (Endophthalmitis)	Evisceration	Fungus filaments	Anophthalmos
3	40/f	AC	13 days	9	Lost to follow up after recurrence noted, patient reviewed at 2 months later	Nil	Not available	Phthisis (noted at 2 months)
4	35/m	GHJ + AC	6 days	11.5	Resolved on medical therapy	AC wash + intracameral injection of amphotericin B	Fungus filaments	Phthisis
5	30/f	GHJ + AC	24 days	11.5	No response to medical therapy	Repeat ThPK	Acremonium species	Clear repeat graft, BCVA 20/50 at 2 months
6	77/m	AC	22 days	11	Resolved on medical therapy	AC wash	Dematiaceous fungus	Clear graft, with BCVA -20/800 at 2 months
7	50/f	GHJ	25 days	9.5	No response	Repeat ThPk	Fusarium species	BCVA 20/1200 at 1 month
8	22/f	AC	6 days	11.5	Slow response	AC wash + intracameral injection of amphotericin B	Fungal filaments	Edematous graft with BCVA HM at 5 months
9	60/m	AC	25 days	9.5	Slow response	AC wash + intracameral injection of amphotericin B	Fungal filaments	Clinical cure, BCVA HM at 1 month
10	35/m	AC	6 days	9	Slow response	ECCE + AV + AC reformation + intracameral amphoptericin-B	Fungal filaments	Failed graft
11	48/m	GHJ + AC + PS	28 days	10	Slow response	TA BCL + AC wash + intravitreal amphotericin B	Fungal filaments	Phthisis at 1 month
12	35/f	GHJ + AC	14 days	8.5	Resolved on medical therapy	Nil	Fungal filaments	Edematous graft, HM at 2 months
13	45/f	AC + PS	1 day	8.5	Posterior segment spread (Endophthalmitis)	PPV + IOAB + Intravitreal Ampho B	Not available	Phthisis
14	45/f	AC + PS	11 days	11	Posterior segment spread (Endophthalmitis)	Evisceration	Fungal filaments	Anophthalmos
15	50/f	AC + PS	11 days	12	Posterior segment spread (Endophthalmitis)	PPV + IOAB + Intravitreal Ampho B, Evisceration	Not available	Anophthalmos
16	40/m	AC	5 days	9.5	Partial response	AC wash + intracameral injection of amphotericin B	Not available	Failed graft at 3 months
17	35/f	AC	6 days	12	Partial response	AC wash + intracameral injection of amphotericin B	Fungus filaments	Failed graft at 2 months
18	35/m	GHJ + AC	14 days	10.5	Partial response	Repeat ThPK	Aspergillus flavus	Edematous graft, BCVA 20/600 at 6 months
19	50/m	GHJ	7 days	8.75	Resolved on medical treatment	Nil	Fungal filaments	BCVA 20/125 at 1 month
20	43/m	GHJ	25 days	11.5	Partial response	Repeat ThPK	Aspergillus flavus	Clear Repeat graft, BCVA 20/80 at 2 months