Microbial keratitis in corneal grafts: predisposing factors and outcomes
| Autor: | W F Siah, H D J Hogg, Francisco C Figueiredo, Hamed M. Anwar, Arthur Okonkwo |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Graft Rejection Male 0301 basic medicine medicine.medical_specialty medicine.medical_treatment 030106 microbiology Visual Acuity medicine.disease_cause Eye Infections Bacterial Corneal Diseases Keratitis Corneal Transplantation 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Patient age Cornea Streptococcus pneumoniae medicine Humans Corneal transplantation Aged Retrospective Studies Aged 80 and over business.industry Incidence Incidence (epidemiology) Middle Aged medicine.disease United Kingdom Surgery Transplantation Ophthalmology medicine.anatomical_structure Clinical Study 030221 ophthalmology & optometry Bullous keratopathy Female business |
| Zdroj: | Eye. 32:775-781 |
| ISSN: | 1476-5454 0950-222X |
| Popis: | PURPOSE: To identify the nature of microbial keratitis in corneal grafts and the clinical outcomes at a tertiary hospital in the United Kingdom. PATIENTS AND METHODS: A retrospective case series of microbial keratitis in corneal grafts at the Royal Victoria Infirmary, Newcastle upon Tyne over a 17-year period (1997–2014). RESULTS: A total of 759 consecutive corneal grafts were identified from the Cornea Transplantation database. Of these, 59 episodes of microbial keratitis occurred in 41 eyes of 41 patients (5.4% 19 male, 46.3%). Median patient age was 73 years (SD=19.4 years). The most common indication for corneal transplantation was bullous keratopathy (11/41, 26.8%). There were 34/59 (57.6%) episodes of culture-positive graft keratitis; Streptococcus pneumoniae and Staphylococcus aureus were each isolated in 5/34 (14.7%) culture-positive episodes. In all, 35/59 (59.3%) episodes of microbial keratitis occurred in 22 previously failed grafts and 3 de novo graft failures. Gram-negative keratitis was more likely to cause reduced BCVA after (χ(2)-test, P=0.02). Median graft duration was 49.5 months (SD=43.7 months). Failed grafts were significantly older (median 69 vs 27 months, P=0.009). CONCLUSION: This represents the longest published follow-up data on microbial keratitis and is the only of its kind in the United Kingdom. The incidence of 5.4% is comparable to that within the developed world. Graft age was significantly associated with graft failure in microbial keratitis; the ongoing risk of microbial keratitis warrants providing patients with long-term open access to hospital eye services. |
| Databáze: | OpenAIRE |
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