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Delayed postoperative interface keratitis due to Enterococcus faecalis after Descemet membrane endothelial keratoplasty
  1. Priyanka Sudana1,
  2. Sunita Chaurasia1,
  3. Joveeta Joseph2 and
  4. Dilip Kumar Mishra3
  1. 1Cornea and Anterior Segment, LV Prasad Eye Institute, Hyderabad, India
  2. 2Jhaveri Microbiology Centre, L V Prasad Eye Institute, Hyderabad, India
  3. 3Ophthalmic Pathology Services, LV Prasad Eye Institute, Hyderabad, India
  1. Correspondence to Dr Sunita Chaurasia; sunita{at}lvpei.org

Abstract

To report the clinical course and management of interface keratitis due to Enterococcus faecalis after Descemet membrane endothelial keratoplasty (DMEK). A 64-year-old man underwent DMEK, with unevenful immediate postoperative course, with a visual recovery of 20/30 at 2 weeks. At 3 months of clinical visit, interface keratitis was noted. DMEK graft removal with stromal bed scrapings was performed. A diagnosis of E. faecalis interface keratitis was made. The patient responded favourably to antibiotic susceptibility-guided intensive treatment with vancomycin 5% with complete resolution of infection. After 2 months of graft removal, Descemet stripping endothelial keratoplasty (DSEK) was performed. The corneal clarity was restored and the best corrected visual acuity was 20/40 at last follow-up of 1 year. E. faecalis should be kept as a differential in delayed onset interface keratitis after DMEK. After microbiological cure with antibiotic therapy, visual rehabilitation with DSEK restores corneal clarity and results in favourable visual outcome.

  • ophthalmology
  • infections

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Footnotes

  • Contributors Concept and design of study: SC. Acquisition of data, analysis and interpretation of data: PS. Initial draft: PS. Final draft, editing, references: SC, JJ, DKM.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.