With the growing popularity of
lamellar keratoplasty for selective replacement of diseased corneal tissue, it is important to understand the risk of developing an
infection after the procedure. Although lesser than that postpenetrating
keratoplasty, the reports on post
lamellar keratoplasty infectious
keratitis are not negligible. Trends of acute
infections arising within 2 months of surgery are a subject of interest. Most of these
infections are reported post Descemet's stripping endothelial
keratoplasty with a preponderance of Candida species. A donor to host transmission of
infection is not uncommon. Among the Candida cases, about 80% seem to occur due to a donor to host transmission.
Infections presenting as or progressing to
endophthalmitis lead to a poor visual outcome. Strict aseptic measures and protocols during corneal
tissue harvesting, tissue processing, tissue storage and surgery are essential to prevent occurrence of these
infections. After the
infection has occurred, determining the aetiology and
drug susceptibility through microbiological testing is vital. This helps to guide treatment protocols and hence determines final outcome of these cases. Most cases require some form of surgical management for resolution of
infection, most often a graft removal and therapeutic
keratoplasty. Secondary surgical interventions are performed to restore graft clarity and achieve a good final visual outcome.