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Late microbial keratitis after corneal transplantation
1Department of Ophthalmology, National Cheng Kung University Hospital, Tainan, Taiwan, ROC.
Cornea
|November 1, 1995
Summary
Late infectious keratitis significantly impacts corneal graft survival after penetrating keratoplasty. Prompt identification and management are crucial to preserve graft clarity and visual outcomes.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Infectious keratitis poses a severe threat to corneal graft survival and visual prognosis following penetrating keratoplasty.
- Late-onset microbial keratitis can lead to graft failure and vision loss.
Purpose of the Study:
- To retrospectively analyze the incidence, precipitating factors, microbial causes, and outcomes of late infectious keratitis after penetrating keratoplasty.
- To identify risk factors and complications associated with post-keratoplasty infectious keratitis.
Main Methods:
- Retrospective review of medical records of 354 consecutive penetrating keratoplasty patients treated for 41 episodes of late microbial keratitis between November 1989 and October 1994.
- Analysis of the time interval from transplantation to infection, precipitating factors, causative organisms, and treatment outcomes.
Main Results:
- Late infectious keratitis occurred at an average of 10.4 months post-transplantation (range: 1-52 months).
- Epithelial defects (49%), suture issues (41%), and contact lens use (17%) were common precipitating factors.
- Gram-positive cocci (51%) and gram-negative bacilli (40%) were identified, with Streptococcus being most frequent. Graft clarity was retained in only 43% of cases.
Conclusions:
- Infectious keratitis following penetrating keratoplasty is a significant cause of graft failure.
- Preventive strategies and close post-operative monitoring are essential to mitigate the risk and impact of graft infections.