Post-Dsaek Microbial Keratitis: Clinical Profile And Outcomes From A Tertiary Eye Care Centre
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR294 | Type: Free paper | DOI: 10.82333/2fgs-9g10
Authors: Dr Sridevi Nair* 1 , Dr Deepak Kumar 1 , A/Prof. Tushar Agarwal 1 , A/Prof. Rajesh Sinha 1 , A/Prof. Manpreet Kaur 1 , A/Prof. Radhika Tandon 1
1OPHTHALMOLOGY,AIIMS, DELHI,DELHI,India
Purpose
To evaluate the clinical characteristics, microbiological profile, risk factors, management, and visual outcomes of infectious keratitis following Descemet stripping automated endothelial keratoplasty (DSAEK).
Setting
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi
Methods
A retrospective review was conducted of patients who developed infectious keratitis following DSAEK at a tertiary eye care centre over a 3 year period. Data analysed included risk factors, time to infection, microbiological findings management strategies, and final visual outcomes.
Results
Thirteen eyes of 13 patients developed post-DSAEK infection (Mean age= 40.9±20.9 years). Median time to presentation was 14 days (mean 137 ± 181.9 days). Interface or deep stromal involvement was observed in 8 eyes. Corneal scraping cultures were positive in 3 eyes (Candida; Candida + Staphylococcus; Acremonium). The mean DET of the DSAEK donor tissue was 10.75 ± 6.26 hours (median 13 hours). Donor rim cultures were positive in 3 cases (Candida/Pseudomonas, Pseudomonas, and Phaeacremonium species). Surgical intervention was required in 8 eyes, including lenticule extraction in 5 and therapeutic PK in 3; 5 eyes were managed medically. Mean DCVA was 1.65 ± 0.47 at 3 months; 46% were finger counting close to face or worse.
Conclusions
Post-DSAEK infectious keratitis represents an uncommon yet potentially sight-threatening complication, often presenting in the early postoperative period. A substantial proportion of cases required surgical intervention, including lenticule explantation or repeat penetrating keratoplasty. Visual outcomes were guarded, with nearly half of the eyes demonstrating severe visual impairment at final follow-up. Vigilant postoperative surveillance and careful donor screening remain essential.