Clinical Outcomes of Infectious Keratitis Associated with Contact Lens Wear Following Penetrating Keratoplasty: A Case Series

PurposeTo report on the clinical characteristics, and outcomes of patients who developed infectious keratitis associated with contact lens (CL) wear following penetrating keratoplasty (PK).MethodsA retrospective chart review was performed to identify all patients who underwent PK between November 2012 and January 2023 at a single tertiary referral practice, and subsequently developed CL related infectious keratitis. 74 patients using CL following PK were identified. Charts were reviewed to obtain data about demographics, ocular history, CL usage, microbial culture reports, visual acuity, treatment, and clinical outcomes.ResultsCL-associated infectious keratitis occurred in 9 patients, more frequently in males (66%), and patients had a mean age of 54.5 +/- 11.8 years old. The identified causative organisms included: Stenotrophomonas maltophilia (N = 3), Candida parapsilosis (N = 2), Moraxella nonliquefaciens (N = 1), Pseudomonas aeruginosa (N = 1), Staphylococcus epidermidis (N = 1), Streptococcus mitis (N = 1), Candida albicans (N = 1), and Acanthamoeba (N = 1). Contact lenses were used following PK for an average of 9.1 +/- 10.8 months before development of keratitis. Patients were followed for 31.8 +/- 30.2 months after infection. The mean best corrected visual acuity without CL prior to infection was 20/150 and decreased to 20/260 post-infection. Complications following the contact-lens-associated infectious keratitis included: central corneal haze (N = 8), chronic corneal epithelial defects (N = 3), perforation (N = 3), endophthalmitis (N = 1), and enucleation (N = 1). Three grafts required repeat PK.ConclusionsCL-associated infectious keratitis following PK have high rates of complication. Patients should be monitored closely for signs of infection.