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Atypical early presentation of graft suture infection

We report an atypical presentation of a corneal graft suture-related abscess. An 80-year-old female with a history of Moraxella and herpetic keratitis successfully treated with penetrating keratoplasty was noted to have a semi-circular pigmented line of keratic precipitates straddling a single suture during a routine follow-up appointment. After 48 hours of oral anti-viral and topical steroid therapy for presumed graft rejection, she developed a suture abscess with hypopyon. Treatment with intensive topical antibiotics was commenced, and the case resulted in complete resolution. Semi-circular endothelial keratic precipitates could be an early sign of suture infection.