PMID- 21045667
OWN - NLM
STAT- MEDLINE
DCOM- 20110510
LR  - 20220318
IS  - 1536-4798 (Electronic)
IS  - 0277-3740 (Linking)
VI  - 30
IP  - 2
DP  - 2011 Feb
TI  - Late-onset deep infectious keratitis after descemet stripping endothelial 
      keratoplasty with vent incisions.
PG  - 229-32
LID - 10.1097/ICO.0b013e3181eae8ff [doi]
AB  - PURPOSE: To report the clinical and histopathological findings of 3 cases of 
      late-onset deep infectious keratitis after Descemet stripping endothelial 
      keratoplasty (DSEK) with vent incisions. METHODS: From a retrospective review of 
      150 consecutive patients who underwent uncomplicated DSEK with vent incisions, 3 
      patients developed late-onset deep infectious keratitis. RESULTS: In case 1, the 
      patient suffered a Pseudomonas corneal ulcer at the nasal vent incision after a 
      dacryocystorhinostomy with stent, 16 months after DSEK. In case 2, a 
      Streptococcus pneumoniae infection developed at the inferior vent incision from a 
      spastic entropion 3 months after surgery. In case 3, an Enterococcus faecalis 
      corneal ulcer presented as a deep stromal abscess in the nasal vent incision 7 
      weeks after DSEK. All cases required full-thickness penetrating keratoplasties. 
      Visual acuities at the last follow-up were counting fingers (case 1), 20/80 (case 
      2), and 20/400 (case 3). CONCLUSIONS: Vent incisions in DSEK may allow bacterial 
      keratitis to penetrate deeply leading to aggressive keratolysis. One must be 
      cautious in using vent incisions in patients with increased bacterial flora and 
      patients with poor ocular surface healing from systemic, local, or mechanical 
      conditions. If vent incisions are performed, a midperipheral oblique incision, 
      parallel to the limbus, with meticulous detail to wound construction is 
      recommended.
FAU - Hannush, Sadeer B
AU  - Hannush SB
AD  - Cornea Service, Wills Eye Institute, Jefferson Medical College, Thomas Jefferson 
      University, Philadelphia, PA, USA. sbhannush@comcast.net
FAU - Chew, Hall F
AU  - Chew HF
FAU - Eagle, Ralph C Jr
AU  - Eagle RC Jr
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Cornea
JT  - Cornea
JID - 8216186
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Corneal Ulcer/microbiology
MH  - Descemet Stripping Endothelial Keratoplasty/*adverse effects/*methods
MH  - *Enterococcus faecalis
MH  - Female
MH  - Follow-Up Studies
MH  - *Gram-Positive Bacterial Infections
MH  - Humans
MH  - Keratitis/*microbiology/pathology/physiopathology/surgery
MH  - Keratoplasty, Penetrating
MH  - Male
MH  - *Pneumococcal Infections
MH  - *Pseudomonas Infections
MH  - Retrospective Studies
MH  - Visual Acuity
EDAT- 2010/11/04 06:00
MHDA- 2011/05/11 06:00
CRDT- 2010/11/04 06:00
PHST- 2010/11/04 06:00 [entrez]
PHST- 2010/11/04 06:00 [pubmed]
PHST- 2011/05/11 06:00 [medline]
AID - 10.1097/ICO.0b013e3181eae8ff [doi]
PST - ppublish
SO  - Cornea. 2011 Feb;30(2):229-32. doi: 10.1097/ICO.0b013e3181eae8ff.