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Microbial keratitis after penetrating keratoplasty.
A K Bates1, C M Kirkness, L A Ficker
1Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfields Eye Hospital, London.
Eye (London, England)
|January 1, 1990
Summary
Microbial keratitis following corneal transplants is common, with Gram-positive bacteria like Streptococcus pneumoniae and Staphylococcus aureus predominating. Poor graft survival and visual outcomes necessitate further research into prevention and treatment.
Area of Science:
- Ophthalmology
- Microbiology
- Transplantation
Background:
- Microbial keratitis is a significant complication following penetrating keratoplasty.
- Understanding risk factors and causative pathogens is crucial for improving graft survival.
Purpose of the Study:
- To identify risk factors, pathogens, and prognosis of microbial keratitis after penetrating keratoplasty.
- To compare indications for keratoplasty in this cohort versus the general population.
Main Methods:
- Retrospective review of thirty cases of microbial keratitis post-penetrating keratoplasty.
- Analysis of microbial cultures, risk factors, graft survival, and visual outcomes.
Main Results:
- Indications for keratoplasty differed significantly, with higher rates of prior microbial keratitis and herpes simplex keratitis.
- Gram-positive organisms, particularly Streptococcus pneumoniae and Staphylococcus aureus, predominated (93% positive cultures).
- Identified risk factors included loose sutures, graft decompensation, and poor ocular surface environment.
Conclusions:
- Microbial keratitis post-keratoplasty has a poor prognosis, with only 23% clear grafts and 53% requiring regrafting.
- Specific risk factors and a distinct microbial spectrum highlight the need for targeted management strategies.