Ocular Infections after Penetrating Keratoplasty

Context: Early diagnosis of ocular infections following penetrating keratoplasty (PK) facilitates the
preservation of useful vision and furthermore prevents the progression of intraocular spread. This
largely depends on the initial clinical presentation and preoperative extensive and laborious ancillary
laboratory investigations.
Objectives of the Study: The aim of this research was to study donor and recipient risk factors for
post-PK ocular infections
Population and Methods: This is an interventional prospective study conducted in 34 patients who
underwent PK under peribulbar anesthesia from 2014 to 2016 at a tertiary based teaching hospital.
Eyes with posterior segment pathology excluded with the inclusion of all other corneal disorders that
caused opacification. Six patients developed signs and symptoms suspicious of postoperative
infections. Statistical analysis performed with MS Excel software.
Results: The mean age was 53 (+/-18.04) years, ranging from 12 to 86 years with 24 (70.59%) males
and 10 (29.41%) females. There were 24 (70.59%) right eyes and 10 (29.41%) left eyes. The mean
age was 63.97 (+/-16.08) years among the donors. Six (17.64%) patients developed postoperative
infections that included one patient with Pseudomonas aeroginosa keratoconjunctivitis, two patients
with fusarium fungal keratitis and surprisingly, observed that failure to establish growth in the
remaining three cases. Positive microbial identification by culture was possible only in three (8.82%)
patients.
Conclusion: Confirming the microbial identification possible only in three patients, and the other three
cases revealed no growth even after one week of incubation. The risk factors found among recipients
were a vegetative injury, dust fall, and eye rubbing, as well as taking a very hot bath. Graft clarity
restoration significantly improved after topical management with fortified antibiotics and antifungal
agents.