Abstract
Interface infectious keratitis (IIK) is a novel corneal infection that may develop after any type of lamellar keratoplasty. Onset of infection occurs in the virtual space between the graft and the host where it may remain localised until spreading with possible risk of endophthalmitis. A literature review identified 42 cases of IIK. Thirty-one of them occurred after endothelial keratoplasty and 12 after deep anterior lamellar keratoplasty. Fungi in the form of Candida species were the most common microorganisms involved, with donor to host transmission of infection documented in the majority of cases. Donor rim cultures were useful to address the infectious microorganisms within few days after surgery. Due to the sequestered site of infection, medical treatment, using both topical and systemic antimicrobials drugs, was ineffective on halting the progression of the infection. Injection of antifungals, right at the graft-host interface, was reported successful in some cases. Spreading of the infection with development of endophthalmitis occurred in five cases after Descemet stripping automated endothelial keratoplasty with severe sight loss in three cases. Early excisional penetrating keratoplasty showed to be the treatment with the highest therapeutic efficacy, lowest rate of complications and greater visual outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 307-314 |
| Number of pages | 8 |
| Journal | British Journal of Ophthalmology |
| Volume | 103 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2019 |
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Keywords
- corneal interface infection
- deep anterior lamellar keratoplasty
- endophthalmitis
- endothelial keratoplasty
- keratitis
ASJC Scopus subject areas
- Ophthalmology
- Sensory Systems
- Cellular and Molecular Neuroscience
Cite this
Interface infectious keratitis after anterior and posterior lamellar keratoplasty. Clinical features and treatment strategies. A review. / Fontana, Luigi; Moramarco, Antonio; Mandarà, Erika; Russello, Giuseppe; Iovieno, Alfonso.
In: British Journal of Ophthalmology, Vol. 103, No. 3, 01.03.2019, p. 307-314.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Interface infectious keratitis after anterior and posterior lamellar keratoplasty. Clinical features and treatment strategies. A review
AU - Fontana, Luigi
AU - Moramarco, Antonio
AU - Mandarà, Erika
AU - Russello, Giuseppe
AU - Iovieno, Alfonso
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Interface infectious keratitis (IIK) is a novel corneal infection that may develop after any type of lamellar keratoplasty. Onset of infection occurs in the virtual space between the graft and the host where it may remain localised until spreading with possible risk of endophthalmitis. A literature review identified 42 cases of IIK. Thirty-one of them occurred after endothelial keratoplasty and 12 after deep anterior lamellar keratoplasty. Fungi in the form of Candida species were the most common microorganisms involved, with donor to host transmission of infection documented in the majority of cases. Donor rim cultures were useful to address the infectious microorganisms within few days after surgery. Due to the sequestered site of infection, medical treatment, using both topical and systemic antimicrobials drugs, was ineffective on halting the progression of the infection. Injection of antifungals, right at the graft-host interface, was reported successful in some cases. Spreading of the infection with development of endophthalmitis occurred in five cases after Descemet stripping automated endothelial keratoplasty with severe sight loss in three cases. Early excisional penetrating keratoplasty showed to be the treatment with the highest therapeutic efficacy, lowest rate of complications and greater visual outcomes.
AB - Interface infectious keratitis (IIK) is a novel corneal infection that may develop after any type of lamellar keratoplasty. Onset of infection occurs in the virtual space between the graft and the host where it may remain localised until spreading with possible risk of endophthalmitis. A literature review identified 42 cases of IIK. Thirty-one of them occurred after endothelial keratoplasty and 12 after deep anterior lamellar keratoplasty. Fungi in the form of Candida species were the most common microorganisms involved, with donor to host transmission of infection documented in the majority of cases. Donor rim cultures were useful to address the infectious microorganisms within few days after surgery. Due to the sequestered site of infection, medical treatment, using both topical and systemic antimicrobials drugs, was ineffective on halting the progression of the infection. Injection of antifungals, right at the graft-host interface, was reported successful in some cases. Spreading of the infection with development of endophthalmitis occurred in five cases after Descemet stripping automated endothelial keratoplasty with severe sight loss in three cases. Early excisional penetrating keratoplasty showed to be the treatment with the highest therapeutic efficacy, lowest rate of complications and greater visual outcomes.
KW - corneal interface infection
KW - deep anterior lamellar keratoplasty
KW - endophthalmitis
KW - endothelial keratoplasty
KW - keratitis
UR - http://www.scopus.com/inward/record.url?scp=85055535733&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055535733&partnerID=8YFLogxK
U2 - 10.1136/bjophthalmol-2018-312938
DO - 10.1136/bjophthalmol-2018-312938
M3 - Review article
VL - 103
SP - 307
EP - 314
JO - British Journal of Ophthalmology
JF - British Journal of Ophthalmology
SN - 0007-1161
IS - 3
ER -