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Infectious keratitis after keratoplasty

Davila, Jose R.; Mian, Shahzad I.

Current Opinion in Ophthalmology: July 2016 - Volume 27 - Issue 4 - p 358–366
doi: 10.1097/ICU.0000000000000269
CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian
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Purpose of review Infectious keratitis is an uncommon but serious complication after corneal transplantation that threatens the visual potential of corneal grafts. Several large retrospective studies from sites worldwide have documented the experiences of corneal surgeons with this sight-threatening complication. The present review synthesizes and compares incidence rates, risk factors, common microorganisms, treatments, and visual prognoses of patients with postkeratoplasty infectious keratitis.

Recent findings In 2012, endothelial keratoplasty replaced penetrating keratoplasty as the most commonly performed corneal transplantation procedure in the United States. Although reported rates of infectious keratitis after endothelial keratoplasty appear to be less than after penetrating keratoplasty, there are still too few publications documenting infectious keratitis after endothelial keratoplasty or anterior lamellar keratoplasty to adequately assess outcomes.

Summary Infectious keratitis continues to be a serious complication among all types of keratoplasty, threatening the viability of the grafted tissues and visual outcomes of patients. Reports from various sites worldwide indicate differences in incidence rates and common infecting microorganisms between high- and middle-income countries. Most reports agree that suture-related problems and factors contributing to a suboptimal ocular surface are the primary risk factors for developing infectious keratitis. In general, patients with infectious keratitis following keratoplasty have a poor visual prognosis because of the difficulty of successful treatment without residual scarring.

Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Michigan, USA

Correspondence to Shahzad I. Mian, MD, Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, 1000 Wall St, Ann Arbor, MI 48105, USA. Tel: +1 734 7635506; fax: +1 734 936 2340; e-mail: smian@umich.edu

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