Titre du document / Document title

Microbial keratitis following penetrating keratoplasty

Auteur(s) / Author(s)

AKOVA Y. A. ⁽¹⁾ ; ONAT M. ⁽¹⁾ ; KOC F. ⁽¹⁾ ; NUROZLER A. ⁽¹⁾ ; DUMAN S. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Ankara Hospital, Department of Ophthalmology, Cornea & External Diseases Unit, Ankara, TURQUIE

Résumé / 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.

Revue / Journal Title

Ophthalmic surgery and lasers   ISSN 1082-3069   CODEN OSLAF2 

Source / Source

1999, vol. 30, n^o6, pp. 449-455 (9 ref.)

Langue / Language

Anglais

Editeur / Publisher

Slack, Thorofare, NJ, ETATS-UNIS  (1995-2000) (Revue)

Mots-clés anglais / English Keywords

Keratoplasty ; Penetrating graft ; Eye ; Keratitis ; Complication ; Postoperative ; Streptococcus pneumoniae ; Risk factor ; Staphylococcus aureus ; Treatment ; Human ; Streptococcaceae ; Micrococcales ; Bacteria ; Micrococcaceae ; Surgery ; Eye disease ; Keratopathy ;

Mots-clés français / French Keywords

Kératoplastie ; Greffe transfixiante ; Oeil ; Kératite ; Complication ; Postopératoire ; Streptococcus pneumoniae ; Facteur risque ; Staphylococcus aureus ; Traitement ; Homme ; Streptococcaceae ; Micrococcales ; Bactérie ; Micrococcaceae ; Chirurgie ; Oeil pathologie ; Kératopathie ;

Mots-clés espagnols / Spanish Keywords

Queratoplastia ; Injerto penetrante ; Ojo ; Queratitis ; Complicación ; Postoperatorio ; Streptococcus pneumoniae ; Factor riesgo ; Staphylococcus aureus ; Tratamiento ; Hombre ; Streptococcaceae ; Micrococcales ; Bacteria ; Micrococcaceae ; Cirugía ; Ojo patología ; Queratopatía ;

Localisation / Location

INIST-CNRS, Cote INIST : 14946, 35400008541907.0040