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Microbial keratitis following penetrating keratoplasty
1Pannu Eye Institute, Lauderdale Lake, Fla.
Abstract:
A retrospective study of 36 cases of infectious keratitis in the graft following 885 consecutive penetrating keratoplasties was conducted to evaluate the spectrum of pathogens and the factors affecting graft survival. Gram positive cocci and gram negative rods were equally responsible (47% in both cases) for 94% of the infections. Epithelial defects were responsible for 64% of the ulcers; suture-related infections, for 36%. After the infectious keratitis resolved, only 50% of the patients had a clear graft. Because the visual prognosis is poor once infectious keratitis develops, aggressive treatment is essential as soon as any sign of infiltration appears.
Insights
Infectious keratitis after corneal transplants is common, with bacteria causing most cases. Prompt treatment is crucial, as only half of grafts remain clear after infection resolution.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Infectious keratitis following penetrating keratoplasty (PKP) poses a significant threat to graft survival and visual outcomes.
- Understanding the causative pathogens and risk factors is essential for effective management.
Purpose of the Study:
- To evaluate the spectrum of pathogens causing infectious keratitis after PKP.
- To identify factors influencing graft survival in these cases.
Main Methods:
- Retrospective analysis of 36 cases of infectious keratitis in corneal grafts.
- Review of 885 consecutive penetrating keratoplasties.
Main Results:
- Gram-positive cocci and gram-negative rods were equally responsible for 94% of infections (47% each).
- Epithelial defects (64%) and suture-related infections (36%) were primary causes.
- Graft clarity was achieved in only 50% of patients post-resolution.
Conclusions:
- Infectious keratitis significantly impairs graft survival after PKP.
- Early detection and aggressive treatment are vital due to poor visual prognosis.