Klin Monbl Augenheilkd 2020; 237(04): 403-405
DOI: 10.1055/a-1081-1723
Der interessante Fall
Georg Thieme Verlag KG Stuttgart · New York

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

Intrastromale und intrakamerale antibiotische Therapie einer bakteriellen Interface-Keratitis nach DMEK
Lucas Janeschitz-Kriegl
1  Ophthalmology, Universitätsspital Basel, Augenklinik, Basel, Switzerland
,
Victoria Dimacali
2  Ophthalmica, Institute of Ophthalmology and Microsurgery, Thessaloniki, Greece
,
Despoina Sagri
2  Ophthalmica, Institute of Ophthalmology and Microsurgery, Thessaloniki, Greece
,
Hendrik P. Scholl
1  Ophthalmology, Universitätsspital Basel, Augenklinik, Basel, Switzerland
,
Zisis Gatzioufas
1  Ophthalmology, Universitätsspital Basel, Augenklinik, Basel, Switzerland
2  Ophthalmica, Institute of Ophthalmology and Microsurgery, Thessaloniki, Greece
,
Miltos Balidis
2  Ophthalmica, Institute of Ophthalmology and Microsurgery, Thessaloniki, Greece
› Author Affiliations
Further Information

Publication History

received 26 September 2019

accepted 26 November 2019

Publication Date:
24 February 2020 (online)

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.