Microbial investigation and clinical features on suture erosions and abscesses after therapeutic corneal transplantation

Abstract

Objective To investigate the microbial profiles and clinical features on suture erosions and abscesses after therapeutic corneal transplantation. Methods Of 11 consecutive cases of suture erosions and abscesses after therapeutic corneal transplantation were enrolled within 2 years, including 9 cases fugal keratitis and 2 cases recurrent stromal keratitis with perforation. In each case, both bacterial and fungal cultures were taken from eroded sutures and conjunctival sac. Clinical features on suture erosions and abscesses were recorded, including therapeutic regimen and results. Results All episodes of suture erosions and abscesses occurred within 3 months postoperatively, on average 31.8 days. Of the 11 cases, 3 had positive cultures and,suture and cul-de-sac cultured micro-organisms matched in 2 cases. Suture erosion and abscess were primarily located superior and palpebral fissure area, with 4 (36.3%) superiorly and 3 (27.3%) palpebrally. Graft rejection in 2 cases was determined clinically. Removal of involved sutures and sensitive topical antibiotic were employed and all cases healed within 1 week. Conclusions Suture erosions and abscesses after therapeutic corneal transplantation occur on early stage, associating with eyelid rubbing, loosening of sutures, contamination and inflammation of bed. Most cases are sterile, gram-positive bacteria are most common cultured organisms in infected ones. Therapeutic strategies are removal of involved sutures and sensitive topical antibiotic. Diagnosis and treatment in a timely fashion contribute to good prognosis. Key words: Therapeutic corneal transplantation ; Suture erosion and abscess ; Microbial feature ;