title: Corneal infections after implantation of intracorneal ring segments.
abstract: OBJECTIVE
  To report risk factors, clinical course, and outcome in patients with infectious keratitis following implantation of intracorneal ring segments (ICRS).
  
  
  METHODS
  The records of 8 patients with culture-proven infectious keratitis after ICRS (Ferrara or Intacs) implantation were retrospectively reviewed. Age, gender, corneal findings, ocular abnormalities, the condition that led to ICRS implantation, immediate prior use of a contact lens, elapsed time between implantation and the onset of symptoms, previous medications, and systemic disorders were noted.
  
  
  RESULTS
  Culture-positive infectious keratitis developed in 7 eyes of 7 patients (2 men and 5 women) with a mean age of 35 years who underwent Ferrara implantation for the treatment of keratoconus and in a 29-year-old man who underwent Intacs implantation for correction of low myopia. Contact lens use, diabetes, and trauma were factors possibly associated with the risk of infection in three cases. Microorganisms, identified in all cases, included Staphylococcus aureus, Streptococcus viridans, Streptococcus pneumoniae, Pseudomonas sp, Nocardia sp, Klebsiella sp, and Paecylomices sp. Onset of symptoms of infection varied from less than 1 week to 22 months postoperatively, depending on the infecting organism.
  
  
  CONCLUSIONS
  Infectious keratitis following ICRS implantation is a sight-threatening complication for which early recognition and rapid institution of appropriate treatment may result in a better visual outcome.
authors.affiliation: Department of Ophthalmology, Federal University of São Paulo/Paulista School of Medicine, Brazil. ana@hoflinglima.med.br
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Hofling-Lima
authors.forename: Bruno Castelo
authors.initials: BC
authors.lastname: Branco
authors.forename: André C
authors.initials: AC
authors.lastname: Romano
authors.forename: Mauro Q S
authors.initials: MQ
authors.lastname: Campos
authors.forename: Hamilton
authors.initials: H
authors.lastname: Moreira
authors.forename: Daniela
authors.initials: D
authors.lastname: Miranda
authors.forename: Sergio
authors.initials: S
authors.lastname: Kwitko
authors.forename: Denise
authors.initials: D
authors.lastname: de Freitas
authors.forename: Fabio H
authors.initials: FH
authors.lastname: Casanova
authors.forename: Fabio
authors.initials: F
authors.lastname: Casanova
authors.forename: Marta
authors.initials: M
authors.lastname: Sartori
authors.forename: Paulo
authors.initials: P
authors.lastname: Schor
authors.forename: Luciene B
authors.initials: LB
authors.lastname: Souza
mesh_terms: D000328:Adult; D001419:Bacteria / Q000302:isolation & purification; D003319:Corneal Stroma / Q000601:surgery*; D020878:Device Removal; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007640:Keratoconus / Q000601:surgery; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D019904:Polymethyl Methacrylate