Infectious keratitis in the corneal graft: treatment with partial conjunctival flaps.
OBJECTIVE
The infection of the corneal graft is one of the most serious complications following keratoplasty. In many instances, it can be treated successfully with intensive topical and subconjunctival antibiotics. However, when this therapy is ineffective, a surgical approach must be considered. The usefulness of partial conjunctival flaps that spare the visual axis for managing corneal graft infections is reported.


METHODS
Retrospective review of four cases. All patients were males between 12 and 85 years old. The four abscesses developed in the penetrating corneal graft during the first year after keratoplasty. The organisms found were Propionibacterium acnes, Candida albicans, Staphylococcus aureus, and Streptococcus pneumoniae. After failure of medical therapy, they were operated on using the partial, thick conjunctival flap technique.


RESULTS
Resolution of the infection and maintenance of a clear graft was achieved in all patients. The follow-up ranged from 5 to 8 years.


CONCLUSIONS
The partial conjunctival flap is an effective surgical procedure for the treatment of abscesses in penetrating keratoplasties when medical treatment has failed.
Geria
Roberto C
RC
Department of Ophthalmology (RCG), Hospital Francés, Buenos Aires, Argentina.
Wainsztein
Ricardo D
RD
Brunzini
Mario
M
Brunzini
Ricardo
R
Geria
Marcos A
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000382:microbiology / Q000601:surgery*; D002648:Child; D003228:Conjunctiva / Q000601:surgery*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000601:surgery*; D006085:Graft Survival; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000601:surgery; D006801:Humans; D007634:Keratitis / Q000382:microbiology / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D008297:Male; D011425:Propionibacterium acnes / Q000302:isolation & purification; D012189:Retrospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000382:microbiology / Q000601:surgery*; D016896:Treatment Outcome