Penetrating Keratoplasty in Herpes Simplex Disease

Freitas, Denise de

doi:10.1016/b978-0-323-06387-6.00134-3

Cited by 1 publication

(2 citation statements)

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“…Perforated eyes need immediate treatment, and large perforations require a PKP 23 . In cases of emergency PKP, the prognosis is worse than in elective surgery 12 , 22 . In the current cohort, emergency LDPKP in herpetic keratitis was performed because of corneal perforation in 5 out of 6 eyes.…”

Section: Discussionmentioning

confidence: 99%

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Large-Diameter Penetrating Keratoplasties are Mostly Due to Very Severe Infectious Keratitis and Cannot Always Prevent Secondary Enucleation

Rangel

Szentmáry

Lepper

et al. 2021

Klin Monbl Augenheilkd

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Purpose To report the indications and outcomes of penetrating keratoplasties with a graft diameter > 8.5 mm in severe corneal diseases at the Department of Ophthalmology at Saarland University Medical Centre. Study Design Retrospective (6 years), descriptive, and observational. Methods Thirty-five large-diameter penetrating keratoplasties (LDPKPs) in 27 patients (mean age, 62 ± 22 years) were performed from March 2010 to December 2016. The indication for surgery, number of previous corneal transplantations, best-corrected visual acuity (BCVA) before surgery, intraocular pressure, graft status, and BCVA at last follow-up were recorded. Results Infectious keratitis represented 83% of the indications (of those, 45% fungal). The mean corneal graft diameter was 10.8 ± 1.7 (min 8.75, max 15.0) mm. Twenty-three eyes (65% absolute) had at least one previous penetrating keratoplasty (mean graft size, 9.2 ± 1.6 mm). The mean pre-surgery BCVA was 1.96 ± 0.23 logMAR. With a mean follow-up period of 20.2 ± 13.4 months, the mean BCVA was 1.57 ± 0.57 logMAR at last follow-up. Overall, 12 grafts (35%) remained clear until the last follow-up, and in 23 grafts (65%), the primary disease recurred, or corneal decompensation developed. Up to the last follow-up, 6 eyes (17%) had to be enucleated. Conclusions In complex cases of infectious keratitis requiring a LDPKP to remove the complete pathology and preserve eye integrity, the visual outcomes are generally expected to be poor, not only because of the well-known risks of LDPKP but also because of the consequences of the infectious disease itself. This knowledge is important for adequate counselling of the patient preoperatively.

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Section: Discussionmentioning

confidence: 99%

“…In the present study, herpes simplex keratitis was the third common LDPKP indication (17 %). In this condition, the goal for the corneal transplantation includes either visual improvement or re-establishment of the integrity of the eye [22]. Perforated eyes need immediate treatment, and large perforations re-quire a PKP [23].…”

Section: Discussionmentioning

confidence: 99%