Bacterial keratitis after primary pediatric penetrating keratoplasty.

Purpose: To determine the prevalence, microbiological profile, and prognosis for bacterial keratitis after primary pediatric penetrating keratoplasty (PKP).

Design: Retrospective case series.

Methods: Retrospective review of all cases of primary PKP performed in children 12 years of age or younger at the King Khaled Eye Specialist Hospital between January 1, 1990 and December 31, 2005 and inclusion of all postoperative cases of culture-positive, bacterial keratitis.

Results: Culture-positive bacterial keratitis developed in 35 (17.3%) of 202 primary keratoplasties. Gram-positive organisms were cultured in 91.4% of infected eyes and accounted for 77.6% of isolates. Streptococcus pneumoniae was the most common organism. No eyes achieved a final visual acuity of 20/40 or better, while 65.7% had hand motions or worse.

Conclusions: Bacterial keratitis after pediatric keratoplasty is a serious complication that is associated with a high risk of graft failure and poor visual outcome.