Interface Drainage and Antimicrobial Irrigation Avoid Repeat
A Study was conducted to describe a surgical technique for the diagnosis and treatment of post–Descemet stripping automated endothelial keratoplasty (DSAEK) infectious interface keratitis presenting as a cold abscess.

Researchers included 2 eyes of 2 patients that developed delayed-onset interface infections after DSAEK. Through an anterior keratotomy, diagnostic samples for microbial culture and histopathology examination were collected, and empiric antibiotic therapy was delivered directly to the site of the infection at the graft–host interface.

Results:
--In both cases, microbiological examinations confirmed a fungal etiology consistent with Candida.

--Resolution of infection was achieved, and no signs of posterior segment involvement or recurrence of infection were observed.

--Both corneas remained clear with final visual acuity of 20/25 and 20/32.

--No case required additional surgical intervention or repeat keratoplasty after more than 15 months of follow-up.

Conclusively, for the treatment of post-DSAEK interface infections manifesting as a peripheral cold abscess, interface drainage with antimicrobial irrigation may be considered. The anterior technique can accomplish clinical clearance of infection, maintain visual function, and protect the DSAEK graft without the need for a therapeutic keratoplasty by avoiding intraocular seeding of infectious microorganisms.

Source: https://journals.lww.com/corneajrnl/Abstract/2021/09000/Interface_Drainage_and_Antimicrobial_Irrigation.25.aspx
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