7-Interface Keratitis Case Study

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7- Interface keratitis: The interface left during DALK is a potential dead space and intraoperative introduction of microorganisms can proliferate within this space without a host immune response. The most common microorganism retrieved from DALK-interface keratitis is Candida (Kanavi et al., 2007). Candida infection occurs due to donor corneal contamination or by the microflora of the conjunctiva and ocular adnexa. After transplantation of a contaminated donor cornea to the recipient bed, development of endophthalmitis is avoided or delayed by the presence of DM separating the site of infection from the intraocular structures. However, the location of infection may make it difficult to obtain specimens for culture and prevent…show more content…
This made DALK a safer alternative for patients at risk for blunt trauma. • Less rigid criteria for donor corneal tissue selection (Shimazaki, 2000) • Low rate of endothelial cell loss either acute or over time. In contrast, endothelial cell loss occurs following PK due to surgical trauma, endothelial cell redistribution, but If the recipient endothelium following DALK is not subjected to significant surgical trauma and shows a physiologic cell loss thereafter, the likelihood of a clear corneal graft throughout life may be higher than with a penetrating keratoplasty (Van Dooren et al., 2004). • Faster visual rehabilitation. • Sutures can be removed at around 3 to 12 months rather than 18 to 24 months for PK. • Possibly lesser induction of astigmatism and lesser follow up time requirement than PK. • A safer procedure in infants and mentally challenged, as in patients with Down syndrome, or other mental alterations. Disadvantages of Deep Anterior lamellar keratoplasty: Deep lamellar keratoplasty is a more time-consuming, surgically more challenging and technically difficult procedure with a variety of complications and a steep learning curve.(Shimazaki,

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