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Murine Corneal Transplantation: A Model to Study the Most Common Form of Solid Organ Transplantation
Published on: November 17, 2014
Microbial keratitis following corneal transplantation
Sujata Das1, Marios Constantinou, Terrence Ong
1Corneal Clinic, Royal Victorian Eye and Ear Hospital, and Centre for Eye Research Australia, Unviersity of Melbourne, Melbourne, Victoria, Australia. sujatadas@bei-lvpei.org
Purpose:
To determine the predisposing risk factors and analyse the clinical and microbiological profiles of microbial keratitis following corneal transplantation.
Methods:
A retrospective analysis was done of hospital records of all patients who presented with microbial keratitis in the corneal graft between July 2000 and June 2005 at the Corneal Unit of Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Results:
Eighty-one episodes of infection were identified in 62 patients over a 5-year period. Thirteen patients had multiple episodes of infection. The mean age of the patients was 70 +/- 16 years (range: 22-92 years). The median time interval between the graft and infection was 17 months (range: 6 days to 385 months). Twenty-two (35%) episodes of primary infection were related to sutures. The associated predisposing risk factors were failed graft (40%), dry eye (18%), Herpes simplex keratitis (8%), and ocular surface disease (8%). Forty-seven (76%) cases were culture positive for bacteria. Ten cases were positive for Herpes simplex virus (HSV) during presentation.
Conclusion:
Failed graft is a long-term risk factor for graft infection in addition to ocular surface disease and H. simplex keratitis. All the predisposing risk factors increase the risk of recurrent graft infection.
Insights
Failed corneal grafts, dry eye, and Herpes simplex keratitis are key risk factors for microbial keratitis after corneal transplantation. These factors increase the likelihood of recurrent graft infections, impacting patient outcomes.
Area of Science:
- Ophthalmology
- Microbiology
- Transplantation Science
Background:
- Microbial keratitis is a serious complication following corneal transplantation.
- Identifying predisposing factors is crucial for preventing graft failure and vision loss.
Purpose of the Study:
- To identify predisposing risk factors for microbial keratitis after corneal transplantation.
- To analyze the clinical and microbiological characteristics of these infections.
Main Methods:
- Retrospective analysis of hospital records from July 2000 to June 2005.
- Inclusion of patients with microbial keratitis in corneal grafts.
- Data collected on patient demographics, graft history, and infection details.
Main Results:
- Eighty-one infection episodes in 62 patients over 5 years; 13 patients had recurrent infections.
- Mean patient age was 70 years; median time to infection was 17 months post-transplant.
- Predisposing factors included failed graft (40%), dry eye (18%), suture-related issues (35%), Herpes simplex keratitis (8%), and ocular surface disease (8%).
- Bacterial and Herpes simplex virus (HSV) were common causative agents.
Conclusions:
- Failed grafts, ocular surface disease, and Herpes simplex keratitis are significant long-term risk factors.
- These predisposing factors elevate the risk of recurrent graft infections.
