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Infectious keratitis after keratoplasty.

Jose R Davila1, Shahzad I Mian

  • 1Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Michigan, USA.

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Infectious keratitis remains a serious risk after corneal transplantation, impacting graft survival and vision. Risk factors vary globally, and treatment challenges often lead to poor visual outcomes.

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Area of Science:

  • Ophthalmology
  • Transplantation Surgery
  • Infectious Diseases

Background:

  • Infectious keratitis is a severe complication following corneal transplantation, jeopardizing graft survival and visual acuity.
  • Corneal transplantation techniques have evolved, with endothelial keratoplasty now more common than penetrating keratoplasty in the US.

Purpose of the Study:

  • To synthesize and compare incidence rates, risk factors, causative microorganisms, treatments, and visual prognoses of postkeratoplasty infectious keratitis.
  • To review global experiences with this sight-threatening complication.

Main Methods:

  • Systematic review and synthesis of large retrospective studies from various international sites.
  • Comparison of data on incidence, risk factors, microbial profiles, and outcomes across different regions and keratoplasty types.

Main Results:

  • Reported infectious keratitis rates appear lower after endothelial keratoplasty compared to penetrating keratoplasty, but data for newer techniques like anterior lamellar keratoplasty are limited.
  • Incidence rates and common pathogens differ between high- and middle-income countries.
  • Suture-related issues and ocular surface compromise are primary risk factors.

Conclusions:

  • Infectious keratitis remains a significant threat to grafted tissues and patient vision across all keratoplasty types.
  • Successful treatment is challenging, often resulting in residual scarring and poor visual prognosis.
  • Further research is needed to adequately assess outcomes for newer keratoplasty procedures.