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Microbial keratitis following penetrating keratoplasty.
Ophthalmic Surg Lasers. 1999 Jun; 30(6):449-55.OS

Abstract

PURPOSE

To investigate the prevalence of microbial keratitis, predisposing risk factors and treatment modalities in patients who developed keratitis following penetrating keratoplasty (PK).

PATIENTS AND METHODS

The records of 285 patients who had undergone PK between January 1991 and December 1995 in a tertiary care center were reviewed. Patients who developed postoperative microbial keratitis were evaluated for predisposing risk factors, microbiological etiology, response to broad spectrum antibiotic therapy and subsequent PK. Patients were mainly treated with fortified topical antibiotics with or without repeat PK.

RESULTS

Of the 285 patient records reviewed, microbial keratitis developed in 21 eyes of 21 patients (7.4%). Seventy-one percent of infections occurred within 6 months after grafting. Keratitis initially began from the donor-recipient border in 16 cases (76.2%) and were central or paracentral in 5 patients. Predisposing risk factors included loose or exposed suture (9), suture removal (1), persistent epithelial defect (3), graft failure (3), contact lens wear (1), Stevens-Johnson syndrome (1). Fifteen (71.4%) patients were culture-positive consisting of Streptococcus pneumoniae (7), Staphylococcus aureus (5), Pseudomonas aureginosa (2), and Hemophilus influenzae (1). Forty-three percent of patients were successfully treated with medical therapy only. Seven patients underwent second PK for visual rehabilitation and 4 for tectonic purposes. After medical and surgical therapy, graft clarity was achieved in 17 (81%) of patients.

CONCLUSIONS

The microbial keratitis following PK is a major postoperative problem affecting the long term prognosis. Careful selection of patients, and preoperative and postoperative control of risk factors, may decrease the frequency of this complication. Several factors, including loose or exposed sutures, epithelial defects, ocular surface disorders, and graft failure, may predispose patients to develop microbial keratitis following PK.

Authors+Show Affiliations

Ankara Hospital, Department of Ophthalmology, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10392732

Citation

Akova, Y A., et al. "Microbial Keratitis Following Penetrating Keratoplasty." Ophthalmic Surgery and Lasers, vol. 30, no. 6, 1999, pp. 449-55.
Akova YA, Onat M, Koc F, et al. Microbial keratitis following penetrating keratoplasty. Ophthalmic Surg Lasers. 1999;30(6):449-55.
Akova, Y. A., Onat, M., Koc, F., Nurozler, A., & Duman, S. (1999). Microbial keratitis following penetrating keratoplasty. Ophthalmic Surgery and Lasers, 30(6), 449-55.
Akova YA, et al. Microbial Keratitis Following Penetrating Keratoplasty. Ophthalmic Surg Lasers. 1999;30(6):449-55. PubMed PMID: 10392732.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Microbial keratitis following penetrating keratoplasty. AU - Akova,Y A, AU - Onat,M, AU - Koc,F, AU - Nurozler,A, AU - Duman,S, PY - 1999/7/7/pubmed PY - 1999/7/7/medline PY - 1999/7/7/entrez SP - 449 EP - 55 JF - Ophthalmic surgery and lasers JO - Ophthalmic Surg Lasers VL - 30 IS - 6 N2 - PURPOSE: To investigate the prevalence of microbial keratitis, predisposing risk factors and treatment modalities in patients who developed keratitis following penetrating keratoplasty (PK). PATIENTS AND METHODS: The records of 285 patients who had undergone PK between January 1991 and December 1995 in a tertiary care center were reviewed. Patients who developed postoperative microbial keratitis were evaluated for predisposing risk factors, microbiological etiology, response to broad spectrum antibiotic therapy and subsequent PK. Patients were mainly treated with fortified topical antibiotics with or without repeat PK. RESULTS: Of the 285 patient records reviewed, microbial keratitis developed in 21 eyes of 21 patients (7.4%). Seventy-one percent of infections occurred within 6 months after grafting. Keratitis initially began from the donor-recipient border in 16 cases (76.2%) and were central or paracentral in 5 patients. Predisposing risk factors included loose or exposed suture (9), suture removal (1), persistent epithelial defect (3), graft failure (3), contact lens wear (1), Stevens-Johnson syndrome (1). Fifteen (71.4%) patients were culture-positive consisting of Streptococcus pneumoniae (7), Staphylococcus aureus (5), Pseudomonas aureginosa (2), and Hemophilus influenzae (1). Forty-three percent of patients were successfully treated with medical therapy only. Seven patients underwent second PK for visual rehabilitation and 4 for tectonic purposes. After medical and surgical therapy, graft clarity was achieved in 17 (81%) of patients. CONCLUSIONS: The microbial keratitis following PK is a major postoperative problem affecting the long term prognosis. Careful selection of patients, and preoperative and postoperative control of risk factors, may decrease the frequency of this complication. Several factors, including loose or exposed sutures, epithelial defects, ocular surface disorders, and graft failure, may predispose patients to develop microbial keratitis following PK. SN - 1082-3069 UR - https://www.unboundmedicine.com/medline/citation/10392732/Microbial_keratitis_following_penetrating_keratoplasty_ DB - PRIME DP - Unbound Medicine ER -