Over a 4-year period (1978–1981), 22 eyes of 19 patients developed microbial keratitis following keratoplasty. Most infections (68%) occurred within the first year following penetrating keratoplasty. The most common indication for keratoplasties which subsequently became infected was corneal perforation (32%), and the most common predisposing factor for infection was the use of a soft contact lens (45%).
Twenty-three organisms were cultured from 20 eyes representing a 91% rate of positive cultures. Of the bacterial organisms, (20), 80% were gram-positive with S. epidermidis representing the most common isolate (35%). There were three cases of fungal keratitis.
The use of low-dose prophylactic antibiotics was associated with infection caused by resistant organisms in 8/13 patients. The use of topical steroids was identified in 68% of patients but was not unequivocably related to an enhanced rate of infection.
Only three patients (14%) retained visual acuity greater than 6/60 and eight patients (36%) required therapeutic surgical intervention.
© Lippincott-Raven Publishers.