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Updated: Aug 14, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Mycobacterium chelonae interface infection after endokeratoplasty
Massimo Busin1, Diego Ponzin, Robert C Arffa
1Casa di Cura Villa Serena, Forlì, Italy. mbusin@alinet.it
Insights
Mycobacterium chelonae can cause serious interface infections after endokeratoplasty. Surgical intervention may be necessary to eradicate the infection when antibiotic therapy fails.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Endokeratoplasty is a surgical procedure for corneal transplantation.
- Interface infections post-keratoplasty can lead to graft failure.
Observation:
- A 74-year-old woman developed interface infiltrates two weeks after endokeratoplasty.
- Cultures of the corneal preservation medium revealed Mycobacterium chelonae.
- Conservative antibiotic treatment with clarithromycin failed.
Findings:
- Penetrating keratoplasty (PK) was performed due to the persistent infection.
- Post-PK surgery, the graft remained clear with no inflammation.
- Cultures from the corneal interface and excised button confirmed Mycobacterium chelonae.
Implications:
- Mycobacterium chelonae should be considered in postoperative corneal interface infections.
- Surgical intervention can be effective in treating refractory cases.
- Early diagnosis and appropriate management are crucial for successful outcomes.
Purpose:
To report a case of interface infection by Mycobacterium chelonae in a patient who underwent endokeratoplasty.
Design:
Interventional case report.
Setting:
Clinical practice.
Methods:
Two weeks after endokeratoplasty, a 74-year-old woman developed multiple enlarging interface infiltrates in her right eye. Cultures performed on the preservation medium grew Mycobacterium chelonae. Penetrating keratoplasty (PK) surgery was performed after failure of conservative antibiotic therapy, including topical and systemic clarithromycin.
Results:
Five months after PK surgery, the graft was clear and no signs of extraocular or intraocular inflammation were present. Cultures taken from the corneal interface at the time of PK surgery confirmed the presence of M. chelonae. Acid-fast bacilli were seen in the excised corneal button.
Conclusions:
M. chelonae should be ruled out as a possible etiologic agent when postoperative infection of the corneal interface occurs. Surgical intervention can lead to eradication of the infection when conservative treatment fails.
