[Infectious keratitis after penetrating keratoplasty].
OBJECTIVE
To investigate the prevalence of microbial keratitis, predisposing risk factors, the spectrum of pathogens and the prognosis for graft survival and visual outcome in patients who developed microbial keratitis following penetrating keratoplasty (PK).


METHODS
and methods: We reviewed 16 cases (15 patients) of microbial keratitis after PK. In all cases, corneal scrapings were obtained and microbiologically analyzed. Efficacy of treatment was evaluated by anatomical (clarity of graft) and visual recovery.


RESULTS
Principal indications for PK were pseudophakic bullous keratopathy (50%) and microbial keratitis in the previous graft (25%). Sixty-three per cent of infections occurred within 1 year of PK. Principal predisposing risk factors were suture-related problems (44%) and microbial keratitis in the previous graft (25%). All of the scrapings were positive according to the microbiological evaluation with gram-positive cocci (64%), gram-positive rods (12%), fungi (18%), and Acanthamoeba (6%). We found 1 case of polymicrobial infection. Best visual and anatomical results were observed in nonadvanced cases and/or these treated early. After medical and surgical treatments, 8 patients (50%) had a clear graft and 10 patients (63%) had visual acuity less than 20/200.


CONCLUSIONS
Postoperative control of risk factors and early recognition of infectious complications may decrease the incidence of severe microbial keratitis after PK.
Tixier
J
J
Pôle Hospitalo-Universitaire d'Ophtalmologie Saint-Antoine Quinze-Vingts, 28, rue de Charenton, 75571 Paris Cedex 12, France.
Bourcier
T
T
Borderie
V
V
Laroche
L
L
D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000382:microbiology / Q000469:parasitology; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000453:epidemiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000453:epidemiology*; D015948:Keratoplasty, Penetrating / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors