Corneal infections after implantation of intracorneal ring segments.
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.
Hofling-Lima
Ana Luisa
AL
Department of Ophthalmology, Federal University of São Paulo/Paulista School of Medicine, Brazil. ana@hoflinglima.med.br
Branco
Bruno Castelo
BC
Romano
André C
AC
Campos
Mauro Q S
MQ
Moreira
Hamilton
H
Miranda
Daniela
D
Kwitko
Sergio
S
de Freitas
Denise
D
Casanova
Fabio H
FH
Casanova
Fabio
F
Sartori
Marta
M
Schor
Paulo
P
Souza
Luciene B
LB
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
D019904:Polymethyl Methacrylate