Clinico-microbiological correlation of suture-related graft infection following penetrating keratoplasty.

Abstract

To report the clinical and microbiological profiles of suture-related graft infections following penetrating keratoplasty. Interventional case series. The medical and microbiology records of all patients who presented with suture-related graft infections and were seen between January 1999 and December 2001 were reviewed. Of 105 patients (105 eyes) who developed corneal infiltrates following penetrating keratoplasty, 37 patients (24 optical and 13 therapeutic) were identified as having suture-related graft infection. The median onset of infiltrates after penetrating keratoplasty was 87 days for 31 patients who presented within one year. Gram-stained smears of corneal scrapings were positive in 27 (73%) of 37 patients, whereas cultures were positive in 32 (only bacteria, 30; mixed bacteria and fungi, 2). Thirty-seven isolates were obtained from 32 patients (gram-positive bacteria, 32; gram-negative bacteria, 3; fungus, 2). All gram-positive isolates were sensitive to cefazolin, chloramphenicol, and vancomycin, whereas one of three gram-negative isolates (Pseudomanas species) was resistant to all the antibiotics tested. Of 32 patients, 30 (82%) responded satisfactorily to medical management. Suture-related graft infections are usually caused by bacteria that are sensitive to ciprofloxacin, cefazolin, and gentamicin, and the patients respond satisfactorily to medical therapy.