Post-DMEK Bacterial Interface Keratitis Treated with Intrastromal and Intracameral Antibiotics

Introduction

New lamellar techniques have been continuously changing the field of corneal transplantation. Compared to traditional penetrating keratoplasty, the replacement of only the diseased endothelium in Descemet membrane endothelial keratoplasty (DMEK) has been shown to result in better visual outcomes, shorter recovery times, and less postoperative complications [1]. However, the resulting interface is a new potential site where infectious microorganisms may be sequestered [2]. Bacterial keratitis is routinely managed with topical medications because high minimum inhibitory concentrations can usually be attained in these cases, hence, an alternate method of drug delivery is rarely necessary [3]. Intrastromal injections are an emerging method of targeted drug delivery that can provide high concentrations of antimicrobials close to the locus of infection. However, clinical evidence for their use in the literature still consists mainly of case reports and small case series [4]. Here, we report a rare case of an acute bacterial DMEK interface keratitis, which we successfully managed with intrastromal and intracameral injections of vancomycin and amikacin.

• References

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