Outcomes of Infectious versus Sterile Perforated Corneal Ulcers after Therapeutic Penetrating Keratoplasty in the United States

Rush, Sloan W; Rush, Ryan B

doi:10.1155/2016/6284595

Cited by 15 publications

(16 citation statements)

References 24 publications

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“…This result is comparable with other studies [ 4 , 18 ]. Groups of patients with extremely large corneoscleral grafts are usually small may be dependent on geographical and ethnic conditions (variability), and statistics may not be representative, which is also emphasized by other authors [ 2 , 4 , 15 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Total Penetrating Keratoplasty: Indications, Therapeutic Approach, and Long-Term Follow-Up

Krysik¹,

Wróblewska‐Czajka

Lyssek-Boroń³

et al. 2018

Journal of Ophthalmology

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Purpose Evaluation of the indications, anatomical and functional results, and complications of total penetrating keratoplasty (TPK) in disorders involving whole cornea. Materials and Methods We analyzed outcomes of the surgical treatment of 47 eyes of 46 patients that underwent TPK. Indications were infectious keratitis, autoimmune disease, injury of the eyeball (mainly chemical burns), and other combined disorders. The surgical technique involved dissection of affected tissues with a margin of 1.0 mm. The size of the corneal graft ranged from 10.0 to 14.0 mm. We analyzed indications, outcomes, and complications of surgery. Results Final restoration of the ocular integrity and maintenance of the globe were achieved in 27 eyes (57%). More than one surgery was necessary in a total of 29 eyes (62%). The frequency of retransplantations did not vary significantly between the groups with different causes of corneal melting/perforation (63% of eyes with infection, 66% of eyes after trauma and 70% of eyes of patients with autoimmune disorders). Surgical treatment failed in 20 eyes (43%). Evisceration was necessary in 13 eyes (28%), phthisis occurred in 7 cases (15%). Conclusion TPK should be considered as a last line treatment in huge corneal destruction to restore integrity of the eye globe.

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Section: Discussionmentioning

confidence: 99%

“…Urgent penetrating keratoplasty (PK), total penetrating keratoplasty (TPK), and corneal or corneoscleral patch graft (CSPG) combination of surgical approaches or keratoprosthesis are usually reserved for progressive, end-stage corneal pathology or last-chance medical treatment [ 1 , 2 , 9 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Total Penetrating Keratoplasty: Indications, Therapeutic Approach, and Long-Term Follow-Up

Krysik¹,

Wróblewska‐Czajka

Lyssek-Boroń³

et al. 2018

Journal of Ophthalmology

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“…Corneal ulcers were considered central if located within 6 mm radius from central apex of cornea, and peripheral if any part of perforation was outside of this limit. 12 …”

Section: Methodsmentioning

confidence: 99%

Outcome of therapeutic penetrating keratoplasty in advanced infectious keratitis

Raj

Bahadur

Dhasmana

2018

Journal of Current Ophthalmology

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PurposeThis study aimed to evaluate the anatomical, therapeutic, and functional outcome of therapeutic penetrating keratoplasty (TPK) in terms of success and failure.MethodsIn this retrospective study 57 eyes of 57 patients were reviewed. They had undergone TPK from December 2012 to June 2017. Data analyzed included the baseline demographic features and characteristics, preoperative diagnosis, and postoperative outcomes. The baseline characteristics included age, gender, laterality, indications of TPK, lens status, size of the recipient, grade of the graft, organisms identified, preoperative best corrected visual acuity (BCVA), secondary procedures, adjunctive surgical procedure, postoperative BCVA at last follow-up, intraocular pressure (IOP), and long-term complications of TPK. The ultimate outcome of TPK was observed in terms of anatomical, therapeutic, and functional outcome which indicated the success and failure.ResultsA total of 57 eyes of 57 with an age range of 2–76-year-old patients who underwent TPK were included in the study. Perforated corneal ulcer was a major indication of TPK in 32 (56.1%) cases. Anatomical success was obtained overall in 49 (85.96%) cases. Indications of TPK and preoperative visual acuity, complications of TPK, and ultimate graft clarity showed significant impact on the anatomical outcome (P = 0.03, P = 0.00, P = 0.00, and P = 0.05), respectively. The therapeutic and functional success was observed in 51 (89.47%) and 40 (70.17%) cases, respectively.ConclusionsPerforated corneal ulcers was the major indication for TPK. Indications and complications significantly affect the anatomical, therapeutic, and functional outcome.

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“…The associations were similar to those in previous studies, while preoperative time was rarely reported. These complications might account for the complicated surgery, with extreme difficulty in thoroughly excising infiltrated area, removing purulent membranes, and separating anterior synechiae 22,23. Hyphema was associated with surgical delay and the use of large graft, and was often due to the presence of refractory infection and multiple neovascularization 24.…”

Section: Discussionmentioning

confidence: 99%

<p>Outcomes of therapeutic keratoplasty for severe infectious keratitis in Chongqing, a 16-year experience</p>

Zhāng

Zhao

et al. 2019

IDR

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Purpose This study aimed to evaluate the outcomes of therapeutic keratoplasty for severe infectious keratitis in Chongqing (Southwest China). Patients and methods The records of 561 eyes that underwent therapeutic keratoplasty for refractory microbial keratitis from 2001 to 2016 were analyzed in this retrospective study. Data included demographic information, microbiological investigations, associated factors, graft size, preoperative status, postoperative complications, and final anatomical outcomes. Results Trauma was the most common cause (267, 47.6%) for corneal ulcers leading to therapeutic keratoplasty. The etiological diagnosis included bacterial keratitis (80 eyes, 14.3%), fungal keratitis (317 eyes, 56.5%), acanthamoeba keratitis (3 eyes, 0.5%), and mixed bacteria/fungal infection (15 eyes, 2.7%). Anatomical success was achieved for 492 eyes (87.7%), with bacterial keratitis having a better outcome than fungal and mixed infections. Diabetes and preoperative time ≥30 days were significantly associated with anatomical failure in the multivariate logistic regression ( P =0.028 and P =0.022, respectively). Patients with hypopyon, corneal perforation, surgical delay, and/or large graft size had a higher incidence of postoperative complications (reinfection, cataract, glaucoma, hyphema, or graft rejection) ( P <0.05). Conclusion Therapeutic keratoplasty was an effective procedure in managing refractory infectious keratitis. Prompt and appropriate surgery would result in fewer complications and better outcomes.

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Outcomes of Infectious versus Sterile Perforated Corneal Ulcers after Therapeutic Penetrating Keratoplasty in the United States

Cited by 15 publications

References 24 publications

Total Penetrating Keratoplasty: Indications, Therapeutic Approach, and Long-Term Follow-Up

Total Penetrating Keratoplasty: Indications, Therapeutic Approach, and Long-Term Follow-Up

Outcome of therapeutic penetrating keratoplasty in advanced infectious keratitis

<p>Outcomes of therapeutic keratoplasty for severe infectious keratitis in Chongqing, a 16-year experience</p>

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