Purpose: To evaluate the background for the onset and outcome of corneal infections after penetrating keratoplasty.
Subjects and methods: The present study included 792 eyes that were subjected to penetrating keratoplasty during a 10-year period from January 1, 2003 to December 31, 2012 at the Department of Ophthalmology of Baptist Eye Clinic or the Department of Ophthalmology, Kyoto Prefectural University of Medicine. The study was retrospectively conducted with regard to the following: 1. incidence, age at onset, and time of onset; 2. the type of phlogogenic pathogen; 3. steroid use at onset; 4. local ocular factors; and 5. visual outcome.
Results: The mean postoperative observation period was 6 years and 8 months, and 23 eyes (2.9%) developed corneal infections. The breakdown was bacterial infection in 11 eyes and fungal infection in 12 eyes. In bacterial infections, drug-resistant bacteria were most frequently detected in 8 out of 11 eyes (72.7%) and, in fungal infections, Candida spp. was most frequently detected in 6 out of 12 eyes (50.0%). Ocular localization factors were suture-related in 18 of 23 eyes (78.3%). There were more patients with fungal infection in whom visual acuity decreased after the infection resolved.
Conclusions: Both bacterial and fungal infections after penetrating keratoplasty developed as opportunistic infections. The most frequently occurring bacterial infection was caused by drug-resistant bacteria, whereas the most frequently occurring fungal infection was caused by Candida spp. For both bacterial and fungal infections, suture-related issues were the most common local ocular factors for infection, and visual outcome was less favorable in those with fungal infections.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 484-493, 2020.