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Therapeutic penetrating keratoplasty for microbial keratitis in Taiwan from 1987 to 2001.
Am J Ophthalmol 2004; 137(4):736-43AJ

Abstract

PURPOSE

To determine the surgical outcomes of therapeutic penetrating keratoplasty (PKP) and its role in the management of microbial keratitis.

DESIGN

Interventional case series.

METHODS

We retrospectively performed a chart review of the hospital records of all 151 patients undergoing therapeutic PKP for culture-proven microbial keratitis at the National Taiwan University Hospital during a 14 year-period (1987-2001). Patients were divided into three categories: (1) bacterial keratitis; (2) fungal keratitis; and (3) acanthamoebic keratitis. Each of the following criteria was evaluated: (1) graft clarity 1 month and 1 year postoperatively; (2) cure of the disease; and (3) anatomical success rate.

RESULTS

A total of 108 therapeutic PKP met the criteria. Therapeutic PKP eradicated the infection in 37/41 of patients with bacterial keratitis, 36/52 of patients with fungal keratitis, and 13/15 of patients with acanthamoebic keratitis. 22/32 of grafts of bacterial keratitis, 20/39 of fungal keratitis, and 11/14 of acanthamoebic keratitis remained clear at 1 year postoperatively. A higher percentage of graft clarity at 1 year postoperatively was achieved in all three categories when grafts were 8.5 mm or less compared with larger grafts. All five patients with secondary endophthalmitis observed at the time of therapeutic PKP experienced a progression of infection despite aggressive surgical treatment, and had to be enucleated.

CONCLUSIONS

Therapeutic PKP is valuable in the management of microbial keratitis that is unresponsive to medical therapy. A higher percentage of clear graft was found when grafts were smaller in all three categories. Surgical results are worse for patients with fungal keratitis, regardless of graft clarity, anatomical success, or infection eradication rate.

Authors+Show Affiliations

Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15059714

Citation

Chen, Wei-Li, et al. "Therapeutic Penetrating Keratoplasty for Microbial Keratitis in Taiwan From 1987 to 2001." American Journal of Ophthalmology, vol. 137, no. 4, 2004, pp. 736-43.
Chen WL, Wu CY, Hu FR, et al. Therapeutic penetrating keratoplasty for microbial keratitis in Taiwan from 1987 to 2001. Am J Ophthalmol. 2004;137(4):736-43.
Chen, W. L., Wu, C. Y., Hu, F. R., & Wang, I. J. (2004). Therapeutic penetrating keratoplasty for microbial keratitis in Taiwan from 1987 to 2001. American Journal of Ophthalmology, 137(4), pp. 736-43.
Chen WL, et al. Therapeutic Penetrating Keratoplasty for Microbial Keratitis in Taiwan From 1987 to 2001. Am J Ophthalmol. 2004;137(4):736-43. PubMed PMID: 15059714.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapeutic penetrating keratoplasty for microbial keratitis in Taiwan from 1987 to 2001. AU - Chen,Wei-Li, AU - Wu,Chun-Ying, AU - Hu,Fung-Rong, AU - Wang,I-Jong, PY - 2003/11/03/accepted PY - 2004/4/3/pubmed PY - 2004/4/28/medline PY - 2004/4/3/entrez SP - 736 EP - 43 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 137 IS - 4 N2 - PURPOSE: To determine the surgical outcomes of therapeutic penetrating keratoplasty (PKP) and its role in the management of microbial keratitis. DESIGN: Interventional case series. METHODS: We retrospectively performed a chart review of the hospital records of all 151 patients undergoing therapeutic PKP for culture-proven microbial keratitis at the National Taiwan University Hospital during a 14 year-period (1987-2001). Patients were divided into three categories: (1) bacterial keratitis; (2) fungal keratitis; and (3) acanthamoebic keratitis. Each of the following criteria was evaluated: (1) graft clarity 1 month and 1 year postoperatively; (2) cure of the disease; and (3) anatomical success rate. RESULTS: A total of 108 therapeutic PKP met the criteria. Therapeutic PKP eradicated the infection in 37/41 of patients with bacterial keratitis, 36/52 of patients with fungal keratitis, and 13/15 of patients with acanthamoebic keratitis. 22/32 of grafts of bacterial keratitis, 20/39 of fungal keratitis, and 11/14 of acanthamoebic keratitis remained clear at 1 year postoperatively. A higher percentage of graft clarity at 1 year postoperatively was achieved in all three categories when grafts were 8.5 mm or less compared with larger grafts. All five patients with secondary endophthalmitis observed at the time of therapeutic PKP experienced a progression of infection despite aggressive surgical treatment, and had to be enucleated. CONCLUSIONS: Therapeutic PKP is valuable in the management of microbial keratitis that is unresponsive to medical therapy. A higher percentage of clear graft was found when grafts were smaller in all three categories. Surgical results are worse for patients with fungal keratitis, regardless of graft clarity, anatomical success, or infection eradication rate. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/15059714/Therapeutic_penetrating_keratoplasty_for_microbial_keratitis_in_Taiwan_from_1987_to_2001_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S000293940301417X DB - PRIME DP - Unbound Medicine ER -