Kocuria kristinae interface keratitis following deep anterior lamellar keratoplasty

A 21-year-old boy underwent deep anterior lamellar keratoplasty (DALK) for advanced keratoconus. Postoperatively, slit lamp examination revealed multiple foci of interface infiltrates. Medical therapy was non-responsive, and therefore, a repeat lamellar transplantation was done. Scrapings were taken from host stroma and under the surface of the initial graft. Microbiological examination, aided by VITEK-2, revealed the causative organism as Kocuria kristinae. The postoperative course was uneventful and at a 1-year follow-up, the graft was clear with no recurrence of infection. This case highlights the pathogenic potential of Kocuria species, which has previously been disregarded as a commensal or contaminant.