Long-term outcomes of therapeutic penetrating keratoplasty for microbial keratitis in a tertiary care center in Turkey

Kasım, Burcu; Koçluk, Yusuf

doi:10.1007/s10792-020-01538-7

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…The study comprised 62.8% male cases, which aligns with findings from the previous literature ( 3 , 16 , 18 ). Males are often more prone to injuries and corneal ulcers than females.…”

Section: Discussionsupporting

confidence: 86%

Tectonic and Therapeutic Urgent Penetrating Keratoplasty Outcomes

Yilmaz

2024

Beyoglu Eye J

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Objectives: It was aimed to to provide a comprehensive assessment of therapeutic and tectonic emergency keratoplasty procedures, along with a discussion on their indications, prognostic factors for functional success, and postoperative outcomes. Methods: Patients who underwent therapeutic or tectonic Penetrating Keratoplasty (PKP) procedures between 2010 to 2021 in our hospital were retrospectively reviewed. Patient files were evaluated in terms of demographic characteristics, medical and ocular history, visual acuity, initial ocular findings, presence of glaucoma, causative microorganisms, details of surgical procedures, complications, graft transparency and globe integrity. Visual acuity was measured as light perception, hand motion, counting finger, Snellen chart and subsequently converted to Logarithm of the Minimum Angle of Resolution (logMAR) for statistical analysis. Results: The study included a total of 43 patients, with 16 (37.2%) being female. The average age of the participants was 59.72±18.1 years. The corrected distance visual acuity improved from 2.3±0.66 logMAR preoperatively to 1.72±1.02 logMAR postoperatively (p=0.001). After PKP, anatomical success was achieved in all eyes and functional success was achieved in 23 (51.1%) eyes. It was observed that only preoperative glaucoma had a significant impact on graft survival rate (p=0.002, Figure 2), as well as functional success (p=0.022). Conclusion: Urgent keratoplasty is a viable treatment option for cases involving an actively uncontrolled infection or corneal disease with perforation. In cases of graft rejection, bacteria, fungi, and viral pathogens were detected as causative agents, whereas only bacteria were detected as the causative agents in cases of pre and post-operative endophthalmitis. Early diagnosis and treatment play crucial roles in achieving anatomical and functional success.

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“…The study comprised 62.8% male cases, which aligns with findings from the previous literature ( 3 , 16 , 18 ). Males are often more prone to injuries and corneal ulcers than females.…”

Section: Discussionsupporting

confidence: 86%

Tectonic and Therapeutic Urgent Penetrating Keratoplasty Outcomes

Yilmaz

2024

Beyoglu Eye J

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“…Our patient underwent therapeutic keratoplasty for infectious keratitis, in which higher rejection rates have been reported (27.3%) [ 9 ]. The rejection is related to acute inflammation caused by the infection and the use of large or eccentric grafts.…”

Section: Discussionmentioning

confidence: 99%

Acute Endothelial Graft Rejection Following COVID-19 Infection

Behera¹,

Gokhale²,

Babu³

2021

Cureus

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Here, we report a case of acute endothelial graft rejection following coronavirus disease 2019 (COVID-19). A 57-year-old woman who underwent therapeutic penetrating keratoplasty for a perforated infectious corneal ulcer in her right eye developed severe acute respiratory syndrome coronavirus 2 infection, which required intensive care and treatment with steroids. Acute endothelial graft rejection was seen at three weeks postoperatively and managed with high-dose corticosteroids. Despite standard therapy, secondary graft failure was observed. Immune dysregulation associated with COVID-19 may be a significant cause of acute endothelial graft rejection among keratoplasty patients with COVID-19.

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“…High-risk PKPs are classically defined as transplants performed in eyes with corneal neovascularization, a history of graft failure, or uncontrolled glaucoma but the definition varies across studies [133,139]. High-risk PKPs have rejection rates up to 60% despite measures, such as systemic immunosuppression [67 ▪ ,75 ▪ ,82 ▪ ,133,138 ▪▪ ,140 ▪▪ ,141,142 ▪ ]. Although some risk factor studies report contradictory findings and risk factor assessment can be complicated by confounding factors, multiple recipient factors are associated with a higher rejection risk (Table 3) [35,53,132,133].…”

Section: Understanding Rejection Riskmentioning

confidence: 99%

Impact of vaccination on keratoplasty

Dugan

2022

Current Opinion in Ophthalmology

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Purpose of reviewCorneal graft rejection has been reported after coronavirus disease 2019 (COVID-19) vaccination. The purpose of this review is to evaluate the literature regarding corneal graft rejection after vaccination, including rejection rates and risk factors. We aim to create a framework to identify patients who are at higher risk for graft rejection and may warrant consideration of prophylactic interventions.Recent findingsGraft rejection has been reported following administration of mRNA, viral vector, and inactivated whole-virion COVID-19 vaccines. Most cases had additional risk factors associated with rejection. Vaccination increases circulation of proinflammatory cytokines, CD4+ and CD8+ T-cell responses, and antispike neutralizing antibody, all of which may contribute to graft rejection. Two prospective studies have found no relationship between recent vaccination and rejection but 20% of cornea specialists report to have seen a vaccine-associated rejection and 22% recommend delaying vaccination in certain circumstances. Many specialists recommend prophylactic topical corticosteroids before and after vaccination to mitigate rejection risk but there is no evidence to support this practice on a wider scale.SummaryOur framework identified 96.8% of penetrating keratoplasty patients with vaccine-associated rejection as higher risk. Further research is needed in order to develop evidence-based guidelines.

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Long-term outcomes of therapeutic penetrating keratoplasty for microbial keratitis in a tertiary care center in Turkey

Cited by 5 publications

References 12 publications

Tectonic and Therapeutic Urgent Penetrating Keratoplasty Outcomes

Tectonic and Therapeutic Urgent Penetrating Keratoplasty Outcomes

Acute Endothelial Graft Rejection Following COVID-19 Infection

Impact of vaccination on keratoplasty

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