Outcome of Therapeutic Keratoplasty in Hopeless Microbial Keratitis Cases Otherwise Advised Evisceration.
| Autor: | Jain R; Department of Ophthalmology, drishtiCONE Eye Care, Shalimar Bagh, Delhi., Bhutia KL; Department of Ophthalmology, Sikkim Manipal Institute of Ophthalmology, Rangpo, Sikkim., Mohan N; Department of Ophthalmology, drishtiCONE Eye Care, Shalimar Bagh, Delhi., Gupta CKC; Department of Ophthalmology, Action Balaji Hospital Delhi, Paschim Vihar, Delhi., Ghai A; Department of Ophthalmology, Sri Guru Gobind Singh Tricentenary University, Gurgaon, Haryana. |
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| Jazyk: | angličtina |
| Zdroj: | Cornea [Cornea] 2018 Feb; Vol. 37 (2), pp. 151-155. |
| DOI: | 10.1097/ICO.0000000000001432 |
| Abstrakt: | Purpose: To study the outcome of therapeutic keratoplasty in severe microbial keratitis cases otherwise advised evisceration. Methods: A retrospective, single-center clinical audit included 28 patients with severe microbial keratitis presenting from April 2014 to April 2016. Patients with microbial keratitis either affecting more than 2 quadrants of the limbus and/or cases with infections involving more than 180 mm of the cornea who were advised evisceration by more than one ophthalmologist were included. Cases with endophthalmitis were excluded. At 3 months, the outcome was "success" if resolution of infection occurred without recurrence and evisceration was not required. Success was termed "complete" if best vision was 6/24 or better and "partial" otherwise. The outcome was termed a "failure" if infection recurred in the graft or the eye was eviscerated. Results: Mean age of the patients (male:female, 17:11) was 49.5 years, and the mean duration of symptoms before surgery was 28.6 days. Evisceration was required in 2/28 cases. The outcome was "success" in 22/28 cases (78.6%)-complete (10/22); partial (12/22)-and "failure" in 6/28 cases. The outcome was poorer in general in fungal keratitis (n = 16) than bacterial keratitis (n = 7). Conclusions: Primary evisceration is best avoided in infections limited to the anterior segment. Even in hopeless cases, every eye deserves a fair chance. |
| Databáze: | MEDLINE |
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