Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Ophthalmology
Published in: International Ophthalmology 5/2017

01-10-2017 | Original Paper

Results of therapeutic penetrating keratoplasty for bacterial and fungal keratitis

Authors: Yusuf Koçluk, Emine Alyamaç Sukgen

Published in: International Ophthalmology | Issue 5/2017

Login to get access

Abstract

Purpose

This study aimed to report the results of therapeutic penetrating keratoplasty (TPKP) performed at early and late stage of keratitis.

Methods

The study involved patients who underwent TPKP surgery due to bacterial, fungal, or mixed (bacterial and fungal) keratitis. The patients were divided into two groups. Group 1 (13 patients) was the patients operated at early stage of corneal abscess formation or in 15 days after the start of keratitis and group 2 (12 patients) was the patients operated at late stage of keratitis or after at least 15 days after the initial appearance of symptoms. Preoperative clinical signs and postoperative results were presented.

Results

At the end of the follow-up period, 13 (100 %) of grafts in the early TPKP group and 10 (83.3 %) of grafts in the late TPKP group remained clear (p = 0.125). Recurrence of infection at last visit after TPKP was 0 (0 %) of cases in group 1, and was 2 (16.7 %) of cases in group 2 (p = 0.125) Therapeutic success was achieved and the eyes were preserved in 23 patients of both groups. Evisceration was performed for a case and phthisis bulbi was seen in a case in group 2. The groups were statistically different regarding the presence of postoperative complications (p = 0.015).

Conclusion

TPKP performed in cases that do not respond medical treatment, in the early phase of the disease, before the lesions reach to limbus and without waiting corneal perforation, may yield better clinical results and less postoperative complications.
Literature
1.
Yalniz-Akkaya Z, Burcu A, Dogan E, Onat M, Ornek F (2015) Therapeutic penetrating keratoplasty for infectious and non-infectious corneal ulcers. Int Ophthalmol 35:193–200CrossRefPubMed
2.
Eiferman RA (1979) Cryotherapy of pseudomonas keratitis and scleritis. Arch Ophthalmol 97:1637–1639CrossRefPubMed
3.
Reynolds MG, Alfonso E (1991) Treatment of infectious scleritis and keratoscleritis. Am J Ophthalmol 112:543–547CrossRefPubMed
4.
Rao GN, Garg P, Sridhar MS (1999) Penetrating keratoplasty in infectious keratitis. In: Brightbill FS (ed) Corneal surgery: theory, technique and tissue, 3rd edn. Mosby, St Louis, pp 518–525
5.
Killingsworth DW, Stern GA, Driebe WT et al (1993) Results of therapeutic penetrating keratoplasty. Ophthalmology 100:534–541CrossRefPubMed
6.
Sony P, Sharma N, Vajpayee RB, Ray M (2002) Therapeutic keratoplasty for infectious keratitis: a review of the literature. CLAO J 28:111–118PubMed
7.
Chen WL, Wu CY, Hu FR, Wang IJ (2004) Therapeutic penetrating keratoplasty for microbial keratitis in Taiwan from 1987 to 2001. Am J Ophthalmol 137(4):736–743PubMed
8.
Sony P, Sharma N, Vajpayee RB, Ray M (2002) Therapeutic keratoplasty for infectious keratitis: a review of the literature. CLAO J 28(3):111–118PubMed
9.
Sharma N, Jain M, Sehra SV et al (2014) Outcomes of therapeutic penetrating keratoplasty from a tertiary eye care centre in Northern India. Cornea 33:114–118CrossRefPubMed
10.
Li C, Zhao GQ, Che CY, Lin J, Li N, Jia WY et al (2012) Effect of corneal graft diameter on therapeutic penetrating keratoplasty for fungal keratitis. Int J Opthalmol 006:698–703
11.
Greenlee EC, Kwon YH (2008) Graft failure: III. Glaucoma escalation after penetrating keratoplasty. Int Ophthalmol 28(3):191–207CrossRefPubMed
12.
Satpathy G, Vishalakshi P (1995) Ulcerative keratitis: microbial profile and sensitivity pattern—a five year study. Ann Ophthalmol 27:301–306
13.
Gopinathan U, Sharma S, Garg P et al (2009) Review of epidemiological features, microbiological diagnosis and treatment outcome of microbial keratitis: experience of over a decade. Indian J Ophthalmol 57:273–279CrossRefPubMedPubMedCentral
14.
McLeod SD, LaBree LD, Tayyanipour R et al (1995) The importance of initial management in the treatment of severe infectious corneal ulcers. Ophthalmology 102:1943–1948CrossRefPubMed
15.
Li C, Zhao GQ, Che CY et al (2012) Effect of corneal graft diameter on therapeutic penetrating keratoplasty for fungal keratitis. Int J Ophthalmol 5:698–703PubMedPubMedCentral
16.
Sharma N, Sachdev R, Jhanji V et al (2010) Therapeutic keratoplasty for microbial keratitis. Curr Opin Ophthalmol 21:293–300PubMed
17.
Shi W, Wang T, Xie L et al (2010) Risk factors, clinical features, and outcomes of recurrent fungal keratitis after corneal transplantation. Ophthalmology 117:890–896CrossRefPubMed
18.
19.
Yao YF, Zhang YM, Zhou P, Zhang B, Qiu WY, Tseng SC (2003) Therapeutic penetrating keratoplasty in severe fungal keratitis using cryopreserved donor corneas. Br J Ophthalmol 87(5):543–547CrossRefPubMedPubMedCentral
20.
Mandell KJ, Colby KA (2009) Penetrating keratoplasty for invasive fungal keratitis resulting from a thorn injury involving Phomopsis species. Cornea 28(10):1167–1169CrossRefPubMed
21.
Gupta G, Feder RS, Lyon AT (2009) Fungal keratitis with intracameral extension following penetrating keratoplasty. Cornea 28(8):930–932CrossRefPubMed
Metadata
Title
Results of therapeutic penetrating keratoplasty for bacterial and fungal keratitis
Authors
Yusuf Koçluk
Emine Alyamaç Sukgen
Publication date
01-10-2017
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 5/2017
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-016-0372-7

Other articles of this Issue 5/2017

International Ophthalmology 5/2017 Go to the issue

Case Report

Sarcoid-like reaction in a patient with uveitis and underlying cancer

Original Paper

Repeatability of ocular biometry with IOLMaster 700 in subjects with clear lens

Original Paper

Is keratoconus more severe in pediatric population?

Original Paper

Red reflex examination in neonates: evaluation of 3 years of screening

Original Paper

C-reactive protein and complement factor H polymorphism interaction in advanced exudative age-related macular degeneration

Original Paper

Ocular surface squamous neoplasia as the initial presenting sign of human immunodeficiency virus infection in 60 Asian Indian patients