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Microbial Keratitis After Penetrating Keratoplasty.

Jen-Pin Sun1, Wei-Li Chen2, Jehn-Yu Huang1

  • 1Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

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Summary

Microbial keratitis following penetrating keratoplasty (PK) is common, with infections occurring both within and after the first year post-surgery. This complication significantly impacts graft survival rates.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Transplantation Surgery

Background:

  • Corneal transplantation, or penetrating keratoplasty (PK), is a common procedure to restore vision.
  • Infectious keratitis is a serious complication that can lead to graft failure after PK.
  • Understanding the incidence and risk factors of microbial keratitis post-PK is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the incidence and microbiological characteristics of microbial keratitis after PK.
  • To evaluate graft survival rates and identify factors influencing graft failure post-PK.
  • To analyze the timing of infectious keratitis episodes relative to PK.

Main Methods:

  • A retrospective observational case series was conducted.
  • Medical records of 51 patients (52 eyes) who developed microbial keratitis after PK between 2000 and 2009 were reviewed.
  • Data collected included incidence, causative microorganisms, graft survival, and associated risk factors.

Main Results:

  • 67 episodes of culture-positive microbial keratitis occurred in 52 eyes following 871 PKs.
  • Infections were observed both within the first year (47.8%) and after the first year (52.2%) post-PK.
  • Gram-positive bacteria were the most common isolates (57.9%), followed by gram-negative bacteria (22.4%) and fungi (19.7%). Graft survival was 34.3%. Suture-related infections decreased graft failure risk (P=.02), while antiglaucoma agent use increased it (P=.01).

Conclusions:

  • Microbial keratitis post-PK is associated with a high rate of graft failure.
  • Infections can manifest at any time after PK, including beyond the first year.
  • Identifying and managing risk factors, such as antiglaucoma agent use, is essential for preserving graft integrity.