{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:32:13Z","timestamp":1787761933308,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:p>Infectious interface keratitis (IIK) is an uncommon but potentially vision-threatening complication following posterior lamellar keratoplasty, including Descemet stripping automated endothelial keratoplasty (EK) and Descemet membrane EK. The interface space allows microbial sequestration, limits antimicrobial penetration, and complicates microbiologic diagnosis. This review summarizes epidemiology, microbiology, clinical presentation, management strategies, and outcomes of IIK after EK, with an emphasis on surgical decision-making. Across reviews and case series, Candida remains the predominant organism causing IIK after EK. In certain cases, selected localized infections may be considered as graft-sparing candidates for interface drainage and\/or directed intrastromal antimicrobial therapy. While others \u2013 particularly fungal and atypical infections \u2013 require escalation to repeat keratoplasty or therapeutic penetrating keratoplasty (TPK). IIK following EK should be approached as a deep-seated infection in an anatomically secluded space. When clinical progression is observed or diagnosis remains uncertain, early intervention and timely \u201csource control\u201d are central to management. Targeted intrastromal and\/or interface therapy may preserve the original EK graft in carefully selected cases, whereas TPK remains the most definitive approach, especially for progressive or medically refractory infection.<\/jats:p>","DOI":"10.4103\/sjopt.sjopt_5_26","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T15:21:35Z","timestamp":1781018495000},"page":"109-112","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Interface keratitis following endothelial keratoplasty"],"prefix":"10.4103","volume":"40","author":[{"given":"Ellen H.","family":"Koo","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"R1-20260610","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1136\/bjophthalmol-2018-312938","article-title":"Interface infectious keratitis after anterior and posterior lamellar keratoplasty. Clinical features and treatment strategies. A review","volume":"103","author":"Fontana","year":"2019","journal-title":"Br J Ophthalmol"},{"key":"R2-20260610","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.jtos.2019.08.001","article-title":"Infectious interface keratitis (IIK) following lamellar keratoplasty: A literature review","volume":"17","author":"Gao","year":"2019","journal-title":"Ocul Surf"},{"key":"R3-20260610","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.survophthal.2020.11.001","article-title":"Infectious keratitis after lamellar keratoplasty","volume":"66","author":"Sharma","year":"2021","journal-title":"Surv Ophthalmol"},{"key":"R4-20260610","doi-asserted-by":"crossref","first-page":"707242","DOI":"10.3389\/fmed.2021.707242","article-title":"Post-keratoplasty infectious keratitis: Epidemiology, risk factors, management, and outcomes","volume":"8","author":"Song","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"R5-20260610","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1097\/ICO.0000000000000778","article-title":"Candida interface infections after descemet stripping automated endothelial keratoplasty","volume":"35","author":"Tsui","year":"2016","journal-title":"Cornea"},{"key":"R6-20260610","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1097\/ICO.0000000000001727","article-title":"Fungal interface keratitis after descemet membrane endothelial keratoplasty","volume":"37","author":"Augustin","year":"2018","journal-title":"Cornea"},{"key":"R7-20260610","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1097\/ICO.0000000000002892","article-title":"Fungal infectious interface keratitis presenting 2 years after descemet membrane endothelial keratoplasty","volume":"41","author":"Vaidya","year":"2022","journal-title":"Cornea"},{"key":"R8-20260610","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1097\/ICO.0000000000001895","article-title":"Donor-related nontuberculous mycobacterial interface infection after descemet membrane endothelial keratoplasty","volume":"38","author":"Van Landeghem","year":"2019","journal-title":"Cornea"},{"key":"R9-20260610","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1097\/ICO.0000000000002058","article-title":"Management of Nocardia interface keratitis after descemet membrane endothelial keratoplasty","volume":"38","author":"Srirampur","year":"2019","journal-title":"Cornea"},{"key":"R10-20260610","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1097\/ICO.0000000000002710","article-title":"Interface drainage and antimicrobial irrigation avoid repeat keratoplasty for post-DSAEK cold interface abscess","volume":"40","author":"Yu","year":"2021","journal-title":"Cornea"},{"key":"R11-20260610","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1097\/ICO.0000000000000192","article-title":"Intrastromal antifungal injection with secondary lamellar interface infusion for late-onset infectious keratitis after DSAEK","volume":"33","author":"Tu","year":"2014","journal-title":"Cornea"},{"key":"R12-20260610","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1097\/ICO.0000000000000205","article-title":"Interface infection after descemet stripping automated endothelial keratoplasty: Outcomes of therapeutic keratoplasty","volume":"33","author":"Nahum","year":"2014","journal-title":"Cornea"},{"key":"R13-20260610","doi-asserted-by":"crossref","first-page":"1250599","DOI":"10.3389\/fcimb.2023.1250599","article-title":"A7-year review of clinical characteristics, predisposing factors and outcomes of post-keratoplasty infectious keratitis: The Nottingham infectious keratitis study","volume":"13","author":"Ong","year":"2023","journal-title":"Front Cell Infect Microbiol"},{"key":"R14-20260610","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1136\/bjophthalmol-2020-318305","article-title":"Early postoperative infection following lamellar keratoplasty: A review","volume":"106","author":"Das","year":"2022","journal-title":"Br J Ophthalmol"},{"key":"R15-20260610","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.3390\/jcm13082326","article-title":"Post-keratoplasty microbial keratitis in the era of lamellar transplants-a comprehensive review","volume":"13","author":"Przybek-Skrzypecka","year":"2024","journal-title":"J Clin Med"},{"key":"R16-20260610","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1097\/ICO.0000000000003102","article-title":"Fungal infection after descemet membrane endothelial keratoplasty: Incidence and outcomes","volume":"42","author":"Wong","year":"2023","journal-title":"Cornea"}],"container-title":["Saudi Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sjopt.sjopt_5_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:10:30Z","timestamp":1787760630000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sjopt.sjopt_5_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/sjopt.sjopt_5_26","relation":{},"ISSN":["1319-4534","2542-6680"],"issn-type":[{"value":"1319-4534","type":"print"},{"value":"2542-6680","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2026-01-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}