Corneal ulcers in corneal transplants

Area of Science:

• Ophthalmology
• Microbiology

Background:

• Corneal ulcers are a potential complication after corneal transplant surgery.
• Understanding risk factors and causative organisms is crucial for preventing vision loss.

Purpose of the Study:

• To investigate the incidence, clinical features, and microbiological profile of corneal ulcers following corneal transplantation.
• To identify associated risk factors and outcomes.

Main Methods:

• Retrospective analysis of 26 eyes that developed corneal ulcers post-keratoplasty.
• Clinical data collection including time to ulceration, associated factors, and visual outcomes.
• Microbiological investigations including Gram stain and cultures.

Main Results:

• An infection rate of 4.9% was observed, with ulcers typically developing 5.5 months post-surgery.
• Associated factors included topical steroid use, loose sutures, bandage lenses, and prior herpes simplex keratitis.
• Bacterial pathogens were identified in 75% of cases, with common organisms including S. epidermidis and P. aeruginosa.
• Visual reduction occurred in 46% of cases, significantly higher in herpetic corneas (88%).

Conclusions:

• Corneal ulcers post-transplant are a significant concern, often linked to topical steroid use and mechanical factors.
• Prompt microbiological diagnosis and appropriate antibiotic therapy, often with gentamicin, are essential.
• Herpetic keratitis cases have a poorer visual prognosis following ulcer development.