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

PURPOSE: To report the clinical and microbiological pro, files of suture-related graft infections following penetrating keratoplasty. DESIGN: Interventional case series. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.