Our Summary

This research paper analyzes the clinical features of corneal interface infections, which are infections that occur within the layers of the cornea. The study was conducted by looking back at the data of eight patients who had these infections after having corneal transplant or corneal refractive surgery.

The onset of the infection occurred between 2 and 30 days after surgery. In some patients, the infection resulted in a cloudy or opaque cornea. In others, a second corneal transplant was needed to treat the infection.

All of the infections that occurred after a corneal transplant were caused by a type of yeast called Candida. Using a technique called in vivo corneal laser confocal microscopy (IVCM), the researchers were able to see that patients with bacterial infections had a lot of dead tissue and signs of inflammation in the cornea. In patients with fungal infections, they could see fungal structures within the cornea.

In conclusion, the study found that corneal interface infections are hard to diagnose early on and often have poor outcomes. However, using IVCM can help with early diagnosis. The types of pathogens that cause these infections may be different from those that cause corneal infections due to trauma.

FAQs

  1. What are corneal interface infections and when do they typically occur after surgery?
  2. What pathogens were identified as causing these infections in the study?
  3. How can in vivo corneal laser confocal microscopy (IVCM) aid in the diagnosis of corneal interface infections?

Doctor’s Tip

A doctor might tell a patient considering a corneal transplant to be aware of the risk of corneal interface infections and to seek immediate medical attention if they experience any symptoms such as increased pain, redness, or decreased vision after surgery. It is important to follow all post-operative care instructions to reduce the risk of infection and have regular follow-up appointments with your eye doctor to monitor for any signs of complications.

Suitable For

Patients who are typically recommended for a corneal transplant include those with the following conditions:

  1. Keratoconus: a progressive thinning and bulging of the cornea, which can lead to distorted vision.

  2. Corneal scarring: due to trauma, infection, or previous surgery, causing decreased vision.

  3. Fuch’s dystrophy: a genetic disorder that causes the cornea to become swollen and cloudy.

  4. Corneal ulcers: open sores on the cornea that can result from infection or injury.

  5. Corneal degeneration: progressive thinning and weakening of the cornea, leading to vision problems.

  6. Corneal dystrophies: inherited disorders that affect the cornea, such as lattice dystrophy or granular dystrophy.

  7. Corneal infections: severe infections that do not respond to other treatments, such as antibiotics or antifungal medications.

  8. Corneal trauma: injuries to the cornea that result in scarring or damage to the corneal tissue.

Patients who have failed to respond to other treatments, such as contact lenses, medications, or corneal cross-linking, may also be recommended for a corneal transplant. It is important for patients to undergo a comprehensive eye examination and consultation with an ophthalmologist to determine if a corneal transplant is the best treatment option for their specific condition.

Timeline

Before corneal transplant:

  1. Patient is diagnosed with a corneal condition that cannot be treated with other methods.
  2. Patient undergoes pre-operative evaluations and tests to determine if they are a suitable candidate for corneal transplant.
  3. Patient is placed on a waiting list for a donor cornea.
  4. Surgery date is scheduled and patient undergoes corneal transplant procedure.

After corneal transplant:

  1. Patient experiences initial discomfort and blurry vision after surgery.
  2. Patient is prescribed eye drops and medications to prevent infection and promote healing.
  3. Patient attends follow-up appointments to monitor progress and check for signs of rejection or infection.
  4. In some cases, patient may develop complications such as corneal interface infections.
  5. If infection occurs, patient may require additional treatment such as medication or a second corneal transplant.
  6. Patient continues to attend regular follow-up appointments to monitor long-term outcomes of the corneal transplant.

What to Ask Your Doctor

Some questions a patient should ask their doctor about corneal transplant include:

  1. What are the risks of developing a corneal interface infection after surgery?
  2. How can I prevent or reduce the risk of developing a corneal interface infection?
  3. What are the symptoms of a corneal interface infection, and when should I seek medical attention?
  4. How is a corneal interface infection diagnosed and treated?
  5. What is the prognosis for patients who develop a corneal interface infection?
  6. Are there any specific precautions or measures I should take after surgery to prevent infection?
  7. How often should I follow up with my doctor after the surgery to monitor for any signs of infection?
  8. Are there any warning signs or red flags that I should be aware of that may indicate the development of an infection?
  9. What are the differences in treatment between bacterial and fungal corneal interface infections?
  10. Is there anything else I should know about corneal interface infections and their management after surgery?

Reference

Authors: Zhang Y, Wang ZQ, Deng SJ, Chen KX, Sun XG. Journal: Zhonghua Yan Ke Za Zhi. 2023 Aug 11;59(8):657-663. doi: 10.3760/cma.j.cn112142-20221029-00549. PMID: 37550974