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.
Dr. Prabhakar Srinivasapuram Krishnacharya
JSS Academy of Higher Education & Research, JSS Medical College Hospital, Mysore, Karnataka, India.
Dr. Raghavender R. Arra
Sankara Eye Hospital, Odisha, India.