Microbial keratitis - a late complication of penetrating keratoplasty

A retrospective review of 323 penetrating keratoplasties performed in Taiwa n between January 1993 and December 1997 revealed that late microbial kerat itis developed in 39 eyes of 36 patients (12.1%). All patients were operate d on by the same surgeon, and all were followed for at least 1 year. The me an interval between the corneal transplantation and the onset of graft infe ction was 8.6 +/- 8.8 months (range 3 weeks-47 months). Predisposing risk f actors for keratitis included chronic blepharitis with poor lid hygiene (43 .6%), suture-related problems (38.5%), dry eyes (28.2%), epithelial defects (25.6%), and use of contact lenses (5.1%). Infectious keratitis was diagno sed within 6 months after keratoplasty in 59% of cases. Positive cultures w ere obtained in 100% of the ulcers; Pseudomonas aeruginosa and Staphylococc us aureus were the most common pathogens. In the final visual outcome asses sment, 30.8% of cases had clear grafts, 20.5% had graft failures, and 10.3% had corneal perforations.