July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Microbial keratitis following corneal transplantation
Author Affiliations & Notes
  • Pauline Khoo
    The University of Sydney, Save Sight Institute, Sydney, New South Wales, Australia
  • Maria Paulina Cabrera Aguas
    The University of Sydney, Save Sight Institute, Sydney, New South Wales, Australia
  • Stephanie L Watson
    The University of Sydney, Save Sight Institute, Sydney, New South Wales, Australia
    Ophthalmology, Sydney Eye Hospital, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Pauline Khoo, None; Maria Cabrera Aguas, None; Stephanie Watson, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 848. doi:
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      Pauline Khoo, Maria Paulina Cabrera Aguas, Stephanie L Watson; Microbial keratitis following corneal transplantation. Invest. Ophthalmol. Vis. Sci. 2019;60(9):848.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To report clinical and microbiological characteristics of patients with microbial keratitis following corneal transplantation.

Methods : A retrospective cohort study included all patients with a clinical diagnosis of microbial keratitis and a history of corneal transplantation undergoing corneal scrape at the Sydney Eye Hospital, Australia from January 2012 to December 2016. Cases were identified from pathology results and hospital coding. Data were collected from medical records. Visual acuity (VA) was recorded and converted from Snellen to logarithm of the minimum angle of resolution (logMAR). The clinical and microbiological profiles and final outcome were evaluated.

Results : 147 cases of 127 patients with a median age of 72 (IQR 48-81 years) and male to female ratio of 1:0.9 were included. 13 patients had multiple episodes of infection. The median time interval between corneal transplantation and onset of infection was 18.9 months (IQR 4.4 – 63.5 months). From the data available, 49 cases had an infection within 1 year from corneal transplant, 35 cases were between 1 – 5 years, and 27 were 5 years or more. The associated predisposing risk factors were topical corticosteroid use (64%), ocular surface disease (16%), and suture-related infection (10%). 122 (83%) cases had a positive microbiology result, the most common microorganisms identified were Staphylococcus aureus (n=35), Staphylococcus epidermidis (n=27), and Pseudomonas aeruginosa (n=9). The median VA at initial and final presentation was 1.7 (IQR 1.3 – 2) and 1.7 (1.2 – 2), respectively (p = 0.190). The median healing time was 16 days (IQR 7 – 38 days). 89% of patients had a poor outcome, and 21 (17%) patients underwent repeat corneal transplant, of which 55% had corneal grafts within less than 1-year before infection.

Conclusions : Microbial keratitis can occur at any time post corneal transplant. To prevent infections, there is a need to implement appropriate preventive measure as well as closely monitor the graft after operation even after 1 year post corneal transplant.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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