Department of Cornea and Anterior Segment, Anand Eye Institute, Hyderabad, India.
Sita Laxmi Glaucoma Center, Anand Eye Institute, Hyderabad, India.
Cornea. 2019 Dec;38(12):1599-1601. doi: 10.1097/ICO.0000000000002058.
To report the clinical course and management of graft-host interface Nocardia keratitis after Descemet membrane endothelial keratoplasty (DMEK).
A 70-year-old man presented with a corneal epithelial defect, stromal edema, graft infiltrate, and graft-host interface infection 5 months after an uneventful DMEK performed for bullous keratopathy in the left eye. Corneal scrapings from the margin of epithelial defect showed gram-positive bacillus, and the organism was identified as Nocardia asteroides.
Intensive and appropriate topical and systemic antibiotic therapy resulted in complete resolution of infection. Three months later, the patient underwent a repeat DMEK, which resulted in clearing of corneal edema and improvement in visual acuity.
Nocardia interface keratitis is a rare entity, which can occur after DMEK. Proper clinical evaluation and microbiological workup helped us in accurate diagnosis and management. Repeat DMEK after complete resolution of the infection resulted in good outcomes regarding corneal clarity and vision improvement.
报告一例在穿透性角膜内皮移植术（DMEK）后发生于供体-受体界面的诺卡菌角膜炎的临床经过和处理方法。
一位 70 岁男性左眼因大泡性角膜病变行 DMEK 术后 5 个月时出现角膜上皮缺损、基质水肿、移植物浸润和供体-受体界面感染。取自上皮缺损边缘的角膜刮片显示革兰阳性杆菌，该病原体被鉴定为星形奴卡菌。
强化且适当的局部和全身抗生素治疗使感染完全消退。3 个月后，患者再次行 DMEK，术后角膜水肿消退，视力提高。
诺卡菌性界面角膜炎是一种罕见疾病，可发生于 DMEK 术后。正确的临床评估和微生物学检查有助于准确诊断和治疗。感染完全消退后再次行 DMEK 可改善角膜透明度和视力。
