Microbial Keratitis Following Corneal Transplantation
Accepted 20 June 2006. published online 24 July 2006.
Purpose
To study clinical and microbiologic characteristics of corneal infections following penetrating keratoplasty (PK).
Design
Retrospective case series.
Methods
Medical records of patients who presented to Duke University Eye Center from January 1, 1999 to July 1, 2005 with microbial keratitis after PK were reviewed.
Results
Forty-four corneal graft infections were reviewed. Mean interval between PK and infection was 26.3 months. Associated conditions included broken or loose sutures (10, 22.7%) and topical corticosteroids (34, 77.3%). Staphylococcal (12, 20.7%) and Pseudomonal (7, 12.1%) species were common pathogens, and fungal species accounted for eight (18.2%) infections. Twelve patients (27.3%) had polymicrobial infections. Thirteen patients (29.5%) underwent repeat PK. Mean postinfection visual acuity at last follow-up was 20/400.
Conclusions
Microbial infections within corneal grafts can occur anytime in the postoperative course and are associated with broken sutures and the use of topical corticosteroids. The diversity of pathogenic organisms, antibiotic resistance, and the potential for poor outcomes supports aggressive management of these infections.
Duke University Eye Center, Duke University Medical Center, Durham, North Carolina
Inquiries to Natalie A. Afshari, MD, Associate Professor of Ophthalmology, Duke University Eye Center, DUMC Box 3802, Durham, NC 27710
Supported by the Research to Prevent Blindness, New York, New York (N.A.A.).
ABSTRACT