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Therapeutic penetrating keratoplasty in severe fungal keratitis using cryopreserved donor corneas.
Br J Ophthalmol 2003; 87(5):543-7BJ

Abstract

AIMS

To investigate whether cryopreserved donor cornea could be used for therapeutic penetrating keratoplasty (PKP) to eradicate the infection, obviate complications, and preserve anatomical integrity in severe fungal keratitis.

METHODS

In this retrospective, consecutive case series, 45 eyes of 45 patients with severe fungal keratitis, which exhibited anterior chamber collapse, corneal perforation, and/or large suppurative corneal infiltrate, received therapeutic PKP after removal of the infected corneal tissue, irrigation of the anterior chamber by 0.2% fluconazole solution, iris dissection of fibrinoid membrane, and iridectomy and therapeutic PKP using corneas cryopreserved at -20 degrees C.

RESULTS

Among 45 eyes, 39 eyes (86.7%) were successfully eradicated the fungal infection without recurrence and maintained their anatomical integrity without any complication. Four of 45 eyes (8.9%) showed postoperative rise of intraocular pressure, of which three were controlled with subsequent antiglaucoma surgeries, whereas one eye needed additional antiglaucoma medications. Two of 45 eyes (4.4%) were enucleated because of uncontrollable fungal infection and secondary retinal detachment, respectively. 23 eyes received subsequent optical PKP and, among them, 21 maintained clear corneal grafts and two suffered from graft failure due to allograft rejections.

CONCLUSION

Cryopreserved donor corneas are effective substitutes in therapeutic PKP to control severe fungal corneal infection and preserve the global integrity, and may offer additional advantages over conventional PKP in reducing allograft rejection, eradicating fungal infection during the postoperative period, and improving the success of optical PKP for visual rehabilitation.

Authors+Show Affiliations

Department of Ophthalmology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, P R China. yaoyuf@mail.hz.zj.cnNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12714387

Citation

Yao, Y-F, et al. "Therapeutic Penetrating Keratoplasty in Severe Fungal Keratitis Using Cryopreserved Donor Corneas." The British Journal of Ophthalmology, vol. 87, no. 5, 2003, pp. 543-7.
Yao YF, Zhang YM, Zhou P, et al. Therapeutic penetrating keratoplasty in severe fungal keratitis using cryopreserved donor corneas. Br J Ophthalmol. 2003;87(5):543-7.
Yao, Y. F., Zhang, Y. M., Zhou, P., Zhang, B., Qiu, W. Y., & Tseng, S. C. (2003). Therapeutic penetrating keratoplasty in severe fungal keratitis using cryopreserved donor corneas. The British Journal of Ophthalmology, 87(5), pp. 543-7.
Yao YF, et al. Therapeutic Penetrating Keratoplasty in Severe Fungal Keratitis Using Cryopreserved Donor Corneas. Br J Ophthalmol. 2003;87(5):543-7. PubMed PMID: 12714387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapeutic penetrating keratoplasty in severe fungal keratitis using cryopreserved donor corneas. AU - Yao,Y-F, AU - Zhang,Y-M, AU - Zhou,P, AU - Zhang,B, AU - Qiu,W-Y, AU - Tseng,S C G, PY - 2003/4/26/pubmed PY - 2003/6/10/medline PY - 2003/4/26/entrez SP - 543 EP - 7 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 87 IS - 5 N2 - AIMS: To investigate whether cryopreserved donor cornea could be used for therapeutic penetrating keratoplasty (PKP) to eradicate the infection, obviate complications, and preserve anatomical integrity in severe fungal keratitis. METHODS: In this retrospective, consecutive case series, 45 eyes of 45 patients with severe fungal keratitis, which exhibited anterior chamber collapse, corneal perforation, and/or large suppurative corneal infiltrate, received therapeutic PKP after removal of the infected corneal tissue, irrigation of the anterior chamber by 0.2% fluconazole solution, iris dissection of fibrinoid membrane, and iridectomy and therapeutic PKP using corneas cryopreserved at -20 degrees C. RESULTS: Among 45 eyes, 39 eyes (86.7%) were successfully eradicated the fungal infection without recurrence and maintained their anatomical integrity without any complication. Four of 45 eyes (8.9%) showed postoperative rise of intraocular pressure, of which three were controlled with subsequent antiglaucoma surgeries, whereas one eye needed additional antiglaucoma medications. Two of 45 eyes (4.4%) were enucleated because of uncontrollable fungal infection and secondary retinal detachment, respectively. 23 eyes received subsequent optical PKP and, among them, 21 maintained clear corneal grafts and two suffered from graft failure due to allograft rejections. CONCLUSION: Cryopreserved donor corneas are effective substitutes in therapeutic PKP to control severe fungal corneal infection and preserve the global integrity, and may offer additional advantages over conventional PKP in reducing allograft rejection, eradicating fungal infection during the postoperative period, and improving the success of optical PKP for visual rehabilitation. SN - 0007-1161 UR - https://www.unboundmedicine.com/medline/citation/12714387/Therapeutic_penetrating_keratoplasty_in_severe_fungal_keratitis_using_cryopreserved_donor_corneas_ L2 - http://bjo.bmj.com/cgi/pmidlookup?view=long&pmid=12714387 DB - PRIME DP - Unbound Medicine ER -