title: Infectious keratitis in severe limbal stem cell deficiency: characteristics and risk factors.
abstract: OBJECTIVE
  To evaluate the incidence, clinical and microbiological characteristics and risk factors of infectious keratitis in patients with limbal stem cell deficiency (LSCD).
  
  
  METHODS
  Retrospective comparative case series of 35 patients with severe LSCD.
  
  
  RESULTS
  The mean follow-up time was 46 months. Infectious keratitis were mainly caused by Gram positive bacteria (94%). Only 7 infections (37%) healed under fortified adapted antibiotics. In 8 cases (42%), amniotic membrane transplantation was required and in 4 cases (21%) «à chaud» keratoplasty was performed. Significant risk factors associated with infectious keratitis were: soft contact lens extended wear, history of persistent epithelial defects, number of quadrants of corneal vascularization, re-epithelialization time after amniotic membrane or corneal transplantation, and use of corticosteroid or cyclosporin eye drops.
  
  
  CONCLUSIONS
  Infectious keratitis in LSCD is frequent and severe. The restoration of the epithelial barrier integrity and a careful use of therapeutic contact lenses may help to prevent infection.
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 06, Research team 968, Institut de la Vision, Paris, France. sanotman1@yahoo.fr
authors.forename: Otman
authors.initials: O
authors.lastname: Sandali
authors.forename: Thomas
authors.initials: T
authors.lastname: Gaujoux
authors.forename: Pablo
authors.initials: P
authors.lastname: Goldschmidt
authors.forename: Djida
authors.initials: D
authors.lastname: Ghoubay-Benallaoua
authors.forename: Laurent
authors.initials: L
authors.lastname: Laroche
authors.forename: Vincent M
authors.initials: VM
authors.lastname: Borderie
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects; D016039:Corneal Transplantation; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007634:Keratitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology* / Q000601:surgery; D008032:Limbic System / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013234:Stem Cells / Q000473:pathology; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine