Clinical Outcomes of Infectious Keratitis Associated with Contact Lens Wear Following Penetrating Keratoplasty: A Case Series

Abstract

Abstract Objectives To report on the clinical characteristics, and outcomes of patients who developed infectious keratitis associated with contact lens wear following penetrating keratoplasty (PK).Methods A retrospective chart review was performed to identify all patients who underwent PK between November 2012 and January 2023 at a single tertiary referral practice, and subsequently developed contact-lens related infectious keratitis. Electronic medical records of 74 identified patients were reviewed to obtain data about demographics, ocular history, contact lens usage, microbial culture reports, visual acuity, treatment, and clinical outcomes.Results Contact-lens-associated infectious keratitis occurred in 9 patients, more frequently in males (66%), and patients had a mean age of 54.5 +/- 11.8 years old. The identified causative organisms included: Moraxella nonliquefaciens (N = 1), Pseudomonas aeruginosa (N = 1), Stenotrophomonas maltophilia (N = 3), Staphylococcus epidermidis (N = 1), Streptococcus mitis (N = 1), Candida albicans (N = 1), Candida parapsilosis (N = 2), and Acanthamoeba (N = 1). Contact lenses were used following PK for an average of 9.1 +/- 10.8 months before development of keratitis. Patients were followed for 31.8 +/- 30.2 months after infection. The mean best corrected visual acuity without contact lenses prior to infection was 20/150 and decreased to 20/260 post-infection. Complications following the contact-lens-associated infectious keratitis included: central corneal haze (N = 8), chronic corneal epithelial defects (N = 3), perforation (N = 3), endophthalmitis (N = 1), and enucleation (N = 1). Three grafts required repeat PK.Conclusions Contact-lens-associated infectious keratitis following PK have high rates of complication. Patients should be monitored closely for signs of infection.