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Infectious keratitis after penetrating keratoplasty: predisposing risk factors and prognosis
Author(s) -
Hassairi A.,
Limaiem R.,
Ben Mrad A.,
Rayhan H.,
Turki R.,
El Matri L.
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2016.0546
Subject(s) - medicine , corneal perforation , keratitis , keratoconus , ophthalmology , visual acuity , incidence (geometry) , retrospective cohort study , bullous keratopathy , surgery , acanthamoeba keratitis , complication , cornea , physics , optics
Purpose To investigate prevalence, predisposing risk factors and prognosis of graft survival in patients who developed infectious keratitis following penetrating keratoplasty (PK). Methods we undertook a retrospective analysis of 16 patients hospitalized at the Institute of Ophthalmology of Tunis for the occurrence of infectious keratitis following PK over an seven‐year period (From March 2009 to March 2016). We excluded all herpetic keratitis secondary to PK. Efficacy of treatment was evaluated by anatomical (clarity of graft) and visual recovery. Results Principal indications for PK were corneal opacity (secondary to infectious keratitis in 2 cases and to trachoma in 2 cases), therapeutic penetrating keratoplasty for corneal perforation in 5 cases, keratoconus in 3 cases, pseudophakic bullous keratopathy in one case and penetrating keratoplasty in children in 3 cases. Principal predisposing risk factors were suture‐related problems (56.25%) followed by topical corticotherapy (43.75%) and persistant epithelial defect in (43.75%). The microbiological examinations were positive in 70.58% of the cases: bacillus Gram +: 66.66%, Bacillus Gram Négatif: 8.33%, amoeba: 8.33% of the cases. We noted two cases of polymicrobial infection. Four patients underwent PK. The infection was solved in 100% of the cases but with opacities of the transplant in 75% and a severe limitation of the visual acuity. Conclusions The development of infectious keratitis after PK is a serious complication that is associated with a high incidence of graft failure and poor visual outcome. Preventive measures are essential and include a regular follow‐up and education of the operated patients.