title: Infectious keratitis after astigmatic keratotomy in penetrating keratoplasty: review of three cases.
abstract: OBJECTIVE
  To present 3 cases in 2 patients of infectious keratitis of the astigmatic keratotomy (AK) site in patients who had previous penetrating keratoplasty.
  
  
  METHODS
  History, clinical examination, chart review, cultures, and laboratory results were obtained from 2 patients with infectious keratitis within the donor stroma of their graft after an AK was performed.
  
  
  RESULTS
  One patient had an early infiltrate of the AK site that was culture negative. This cleared with fortified antibiotics, and the patient had a final visual acuity of 20/30-2. The second patient developed 2 late infections, the first with coagulase negative Staphylococcus and the second infection with Pseudomonas aeruginosa. Both of these infections cleared with fortified antibiotics, and the final visual acuity was 20/25. Neither patient developed a rejection episode from the infections, and both grafts survived.
  
  
  CONCLUSIONS
  We report a series of 3 cases of infectious keratitis in 2 patients after AKs in corneal grafts. This, to the best of our knowledge, has not been previously reported. Patients who suffer infectious keratitis after AK in corneal grafts may have good visual outcomes if managed with appropriate antibiotic regimens and closely followed.
authors.affiliation: Department of Ophthalmology, University of California, Davis, School of Medicine, Sacramento, 95817, USA.
authors.forename: Sean D
authors.initials: SD
authors.lastname: Adrean
authors.forename: Rochelle
authors.initials: R
authors.lastname: Cochrane
authors.forename: Charles D
authors.initials: CD
authors.lastname: Reilly
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Mannis
mesh_terms: D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D002437:Cefazolin / Q000627:therapeutic use; D003315:Cornea / Q000382:microbiology; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D015818:Eye Infections, Bacterial; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016849:Keratitis, Herpetic / Q000601:surgery; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D007646:Keratotomy, Radial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D014031:Tobramycin / Q000627:therapeutic use
chemical_list: D002437:Cefazolin; D014031:Tobramycin