Mycobacterium chelonae interface infection after endokeratoplasty

PURPOSE: To report a case of interface infection by Mycobacterium chelonae in a patient who underwent endokeratoplasty. DESIGN: Interventional case report. SETTING: Clinical practice. METHODS: Two weeks after endokeratoplasty, a 74-year, old woman developed multiple enlarging interface infiltrates in her right eye. Cultures performed on the preservation medium grew Mycobacterium chelonae. Penetrating keratoplasty (PK) surgery was performed after failure of conservative antibiotic therapy, including topical and systemic clarithromycin. RESULTS: Five months after PK surgery, the graft was clear and no-signs of extraocular or intraocular inflammation were present. Cultures taken from the corneal interface at the time of PK surgery confirmed the presence of M. chelonae. Acid-fast bacilli were seen in the excised corneal button. CONCLUSIONS: M. chelonae should be ruled out as a possible etiologic agent when postoperative infection of the corneal interface occurs. Surgical intervention can lead to eradication of the infection when conservative treatment fails. (C) 2003 by Elsevier Science Inc. All rights reserved.