Microbial keratitis after penetrating keratoplasty

Abstract

SummaryThirty cases of microbial keratitis after penetrating keratoplasty were reviewed to examine the associated risk factors, the spectrum of pathogens and the prognosis for graft survival and visual outcome.The indications for keratoplasty in this group differed markedly from those for all corneal grafts performed with a much higher incidence of previous microbial kera titis and of herpes simplex keratitis.A positive culture was obtained in 93% of cases and in contrast to microbial kera titis overall, Gram positive organisms predominated particularly streptococcus pneumoniae and staphlycoccus aureus.Risk factors identified were loose or broken sutures, graft decompensation and a poor ocular surface environment.There was a poor prognosis for graft survival with only 23% of cases retaining a clear graft. Overall 53% of cases were regrafted. A positive culture was defined as growth of more than one colony of an organism in the inoculating streak of any culture medium.In most cases multiple colonies were grown. Culture media routinely used were blood agar, Sabouraud's medium, thioglycol late medium, nutrient broths and where indi cated Eschrichia Coli seeded non-nutrient agar for Acanthamoeba.

Persistent epithelial defects and ulcers in repeated corneal transplantation: incidence, causative agents, predisposing factors and treatment outcomes

“…In our series, 9% of the regrafts developed ulcers. This was within the range of 1.76-11.9% reported for primary corneal transplantation [5][6][7][8][9][10]. Thus, the overall incidence of persistent epithelial defects and ulcers in our series of repeated grafts did not exceed the incidence of other studies pertaining to primary keratoplasty, although it would be expected that in regrafts it would be higher.…”

“…Indeed, epithelial defects were reported to be the most common risk factor for development of ulcers in primary corneal grafts by others [9,10].…”

“…In contrast to epithelial defects, corneal graft ulcers have been studied after primary corneal transplantation, but not in repeated transplantation [5][6][7][8][9][10][11][12]. Repeated corneal grafts represent a group with high risk for failure compared with primary grafts.…”

Graft survival and risk factors of penetrating keratoplasty for microbial keratitis

“…Reported incidences in the literature vary between 1 . 8 4 9 % (Bates et al 1990;Fong et al 1988). The recurrence rate detected in this study (24% in 5 years) is substantially higher.…”

Contaminação de halos doadores córneo-esclerais em ceratoplastia penetrante no Hospital de Clínicas de Porto Alegre

“…Claudete Inês Locatelli 6 Contaminação de halos doadores córneo-esclerais em ceratoplastia penetrante no Hospital de Clínicas de Porto Alegre INTRODUÇÃO A ocorrência de endoftalmite e de ceratite infecciosa precoce pós-ceratoplastia penetrante são eventos raros, acometendo, respectivamente, entre 0,10 a 0,77% e entre 1,8 a 4,9% dos pacientes submetidos ao procedimento (1)(2)(3)(4)(5)(6)(7)(8)(9)(10) . No entanto, quando ocorrem são situações graves, colocando em risco não somente o transplante, mas também toda a estrutura ocular.…”