Clinical And Microbiological Profile Of Post-Keratoplasty Infectious Keratitis

To evaluate the epidemiological characteristics of patients who develop infectious keratitis (IK) following corneal transplantation.

University of Health Sciences, Bursa City Hospital, Department of Ophthalmology ,Bursa, Turkey.

This retrospective study reviewed the medical records of patients who underwent keratoplasty between 2021 and 2025 years. Patient demographics, primary diagnoses, surgical techniques, follow-up duration, and the presence of IK were recorded. In patients diagnosed with IK, the interval between keratoplasty and infection onset, microorganisms isolated from corneal scraping cultures, predisposing risk factors, history of topical steroid use, and time to clinical resolution were analyzed.

A total of 213 patients (110 males and 103 females) with a mean age of 62.04 ± 17.88 years were included. The most frequent indications for keratoplasty were bullous keratopathy (35.7%) and Fuchs’ endothelial dystrophy (15.5%). Penetrating keratoplasty (PK) was performed in 41.3% of patients, Descemet membrane endothelial keratoplasty (DMEK) in 44.6%, and deep anterior lamellar keratoplasty (DALK) in 14.1%. Infectious keratitis developed in 16 eyes (7.5%), and culture results were positive in 7 cases (43.7%). In total, 68.75% of keratitis cases occurred in the first year after surgery. Fifty% of the infectious keratitis cases occurred after PK, 31.25% after DALK, and 18.75% after DMEK. (p < 0.05)

Infectious keratitis remains a significant complication after corneal transplantation, most commonly occurring after PK and DALK procedures and within the first year postoperatively. Careful management and close follow-up are essential during the early postoperative period.