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TitreAtypical mycobacterial interface infection after Descemet Membrane Endothelial Keratoplasty
Abstract Nr.3020
ButCorneal transplantation procedures are increasingly performed, with a current dominance of newer lamellar corneal transplantation techniques over penetrating keratoplasty. These lamellar techniques also changed the spectrum of post-operative infectious keratitis, as there is a risk of corneal infection at the interface of graft and host tissue. Interface infections require early and intensive medical treatment, which can be difficult due to late presentation and diagnostic delay. Surgical intervention is often necessary to reach resolution.
MéthodesRetrospective case report
RésultatsWe describe the case of a 76-year-old man who developed infectious interface keratitis after descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy. After uneventful DMEK with normal initial postoperative evolution, cultures of the donor cornea transport medium isolated Mycobacterium chelonae. Subsequent clinical investigation showed early signs of infectious keratitis with multiple small infiltrates at the donor-graft interface. Due to unsuccessful medical therapy, exchange of the DMEK graft was necessary, four and a half months after initial DMEK. Early postoperative results showed corneal oedema without clear signs of persistent infection. Cultures at the cornea bank of origin eventually showed M. chelonae as well, indicating a donor related infection.
ConclusionAlthough atypical mycobacteria are a rare cause of interface infection, multiple cases have been published. In all of these cases older techniques of lamellar keratoplasty were used. To the best of our knowledge, this is the first case of donor-related atypical mycobacterial interface keratitis after DMEK.
Conflit d'intérêtNon
Auteur 1
NomVAN LANDEGHEM
InitialesR
InstitutUZ Leuven
VilleLeuven
Auteur 2
NomFoets
InitialesB
InstitutUZ Leuven
VilleLeuven
Auteur 3
NomDesmet
InitialesS
InstitutUZ Leuven
VilleLeuven
Auteur 4
NomVanhaecke
InitialesM
InstitutBiobank UZ Leuven
VilleLeuven
Auteur 5
NomHua
InitialesMT
InstitutUZ Leuven
VilleLeuven
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