Evisceration And Enucleation In Microbial Keratitis: Organisms, Resistance, And Patient Factors
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR193 | Type: Free paper | DOI: 10.82333/jfan-4g37
Authors: A/Prof. Samar Al-Swailem* 1 , A/Prof. Ahmed Mousa 2
1Medical Staff,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia, 2Research Department,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia
Purpose
Severe microbial keratitis can cause vision loss requiring eye removal. This study describes the clinical profile, microbial spectrum, and risk factors for cases of microbial keratitis (MK) requiring evisceration or enucleation
Setting
A retrospective cohort study was conducted at a tertiary referral eye center.
Methods
A retrospective review was conducted of 69 culture-positive MK cases managed with evisceration or enucleation between 2014 and 2022. Data on demographics, presenting features, ocular and systemic comorbidities, microbiology, antimicrobial susceptibility, and clinical course were collected and analyzed.
Results
Most patients were male (63.8%) with a mean age of 64.6 years. Hypertension (44.9%) and diabetes (46.4%) were common comorbidities. Most eyes (81.2%) presented with no light perception. Frequently associated ocular conditions included pseudophakia (36.5%), glaucoma (35.7%), topical steroid use (12.4%), and vitrectomy (7.1%). Endophthalmitis or panophthalmitis occurred in 58% of cases. Streptococci (32.6%) and Staphylococcus (25.6%) were the most frequently isolated organisms. Penicillin resistance was observed in 32.6%, while 37.2% of isolates were sensitive to clindamycin
Conclusions
Microbial keratitis requiring globe removal is linked to advanced disease, comorbidities, and severe intraocular involvement. Early recognition and referral are key to preventing serious consequences.