BACKGROUND: To report two cases of corneal infection after Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS: Two eyes of two patients demonstrated varying clinical presentations of microbial keratitis after DSAEK. At the initial presentation, the keratitis involved the host cornea alone in case 1, whereas in case 2, the posterior lamellar disk alone was involved. A pair of microvitrectomy scissors was used in case 2 from the side port to obtain a 2-mm sample of the posterior lamellar disk for microbiologic evaluation. The keratitis did not respond to medical therapy, and therapeutic penetrating keratoplasty was performed to resolve the infection in both the eyes. The main outcome measures were resolution of infection, absence of recurrence of keratitis, graft clarity, and visual outcome. RESULTS: There was complete resolution of infection after full thickness therapeutic grafts with best-corrected visual acuities of 20/60 and 20/40, respectively. CONCLUSIONS: Initial presentation of microbial keratitis after DSAEK may involve either the host or the posterior lamellar disk alone. A microvitrectomy scissors through the side port may be used for biopsy of posterior lamellar disk in recalcitrant infection.
BACKGROUND: To report two cases of corneal infection after Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS: Two eyes of two patients demonstrated varying clinical presentations of microbial keratitis after DSAEK. At the initial presentation, the keratitis involved the host cornea alone in case 1, whereas in case 2, the posterior lamellar disk alone was involved. A pair of microvitrectomy scissors was used in case 2 from the side port to obtain a 2-mm sample of the posterior lamellar disk for microbiologic evaluation. The keratitis did not respond to medical therapy, and therapeutic penetrating keratoplasty was performed to resolve the infection in both the eyes. The main outcome measures were resolution of infection, absence of recurrence of keratitis, graft clarity, and visual outcome. RESULTS: There was complete resolution of infection after full thickness therapeutic grafts with best-corrected visual acuities of 20/60 and 20/40, respectively. CONCLUSIONS: Initial presentation of microbial keratitis after DSAEK may involve either the host or the posterior lamellar disk alone. A microvitrectomy scissors through the side port may be used for biopsy of posterior lamellar disk in recalcitrant infection.
Authors: Sotiria Palioura; Kavitha Sivaraman; Madhura Joag; Adam Sise; Juan F Batlle; Darlene Miller; Edgar M Espana; Guillermo Amescua; Sonia H Yoo; Anat Galor; Carol L Karp Journal: Cornea Date: 2018-04 Impact factor: 2.651
Authors: Luigi Fontana; Alice Caristia; Alessandra Cornacchia; Giuseppe Russello; Antonio Moramarco Journal: Int Ophthalmol Date: 2020-09-17 Impact factor: 2.031
Authors: Shahzad I Mian; Anthony J Aldave; Elmer Y Tu; Brandon D Ayres; Bennie H Jeng; Marian S Macsai; Michael L Nordlund; Jeffrey G Penta; Sudeep Pramanik; Loretta B Szczotka-Flynn; Allison R Ayala; Wendi Liang; Maureen G Maguire; Jonathan H Lass Journal: Cornea Date: 2018-09 Impact factor: 2.651
Authors: Luigi Fontana; Antonio Moramarco; Erika Mandarà; Giuseppe Russello; Alfonso Iovieno Journal: Br J Ophthalmol Date: 2018-10-24 Impact factor: 4.638