Endophthalmitis following Keratoplasty: Incidence, Microbial Profile, Visual and Structural Outcomes

Purpose: To identify the causative organisms of post-keratoplasty endophthalmitis and to report its visual and structural outcomes. Methods: A chart review was performed of all patients diagnosed with endophthalmitis after keratoplasty at a tertiary hospital between January 1990 and January 2007. Results: Endophthalmitis developed in 55 cases in the penetrating keratoplasty group and in no cases in the lamellar keratoplasty group. The majority of isolated microbes were gram-positive (86.3%). Only 1 eye retained a clear graft with 20/25 vision; other cases had <= 20/200 vision. Four of 13 eyes that underwent vitrectomy and 28 of 42 that did not undergo vitrectomy ended up with no light perception. One eye that underwent vitrectomy and 21 eyes that did not undergo vitrectomy were eviscerated. Conclusions: Post-keratoplasty endophthalmitis was associated with poor visual and structural outcome. Gram-positive organisms were the most common cause of infection. Early vitrectomy may reduce functional and structural damage associated with endophthalmitis.