Infectious keratitis after keratoplasty

Infectious keratitis is an uncommon but serious complication after corneal transplantation that threatens the visual potential of corneal grafts. Several large retrospective studies from sites worldwide have documented the experiences of corneal surgeons with this sight-threatening complication. The present review synthesizes and compares incidence rates, risk factors, common microorganisms, treatments, and visual prognoses of patients with postkeratoplasty infectious keratitis.

In 2012, endothelial keratoplasty replaced penetrating keratoplasty as the most commonly performed corneal transplantation procedure in the United States. Although reported rates of infectious keratitis after endothelial keratoplasty appear to be less than after penetrating keratoplasty, there are still too few publications documenting infectious keratitis after endothelial keratoplasty or anterior lamellar keratoplasty to adequately assess outcomes.

Infectious keratitis continues to be a serious complication among all types of keratoplasty, threatening the viability of the grafted tissues and visual outcomes of patients. Reports from various sites worldwide indicate differences in incidence rates and common infecting microorganisms between high- and middle-income countries. Most reports agree that suture-related problems and factors contributing to a suboptimal ocular surface are the primary risk factors for developing infectious keratitis. In general, patients with infectious keratitis following keratoplasty have a poor visual prognosis because of the difficulty of successful treatment without residual scarring.