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Early postoperative infection following lamellar keratoplasty: a review
  1. Shilpa Das1,
  2. Sunita Chaurasia2,
  3. Savitri Sharma3,
  4. Sujata Das4
  1. 1 Cornea Service, Narayana Nethralaya, Bengaluru, Karnataka, India
  2. 2 Cornea & Anterior Segment Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
  3. 3 Jhaveri Microbiology Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
  4. 4 Cornea & Anterior Segment Service, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
  1. Correspondence to Dr Sujata Das, Cornea & Anterior Segment Service, LV Prasad Eye Institute, Bhubaneswar, Odisha, India; sujatadas{at}


With the growing popularity of lamellar keratoplasty for selective replacement of diseased corneal tissue, it is important to understand the risk of developing an infection after the procedure. Although lesser than that postpenetrating keratoplasty, the reports on post lamellar keratoplasty infectious keratitis are not negligible. Trends of acute infections arising within 2 months of surgery are a subject of interest. Most of these infections are reported post Descemet’s stripping endothelial keratoplasty with a preponderance of Candida species. A donor to host transmission of infection is not uncommon. Among the Candida cases, about 80% seem to occur due to a donor to host transmission. Infections presenting as or progressing to endophthalmitis lead to a poor visual outcome. Strict aseptic measures and protocols during corneal tissue harvesting, tissue processing, tissue storage and surgery are essential to prevent occurrence of these infections. After the infection has occurred, determining the aetiology and drug susceptibility through microbiological testing is vital. This helps to guide treatment protocols and hence determines final outcome of these cases. Most cases require some form of surgical management for resolution of infection, most often a graft removal and therapeutic keratoplasty. Secondary surgical interventions are performed to restore graft clarity and achieve a good final visual outcome.

  • Infection
  • Cornea
  • Microbiology

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  • Collaborators N/A.

  • Contributors All the authors included in this paper fulfill the criteria of authorship.

  • 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.

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