Long-term results in therapeutic keratoplasty for treating infectious keratitis: review of 24 cases

Session Details

Session Title: Ocular Infections & Other Topics

Session Date/Time: Sunday 15/09/2019 | 08:00-10:00

Paper Time: 08:30

Venue: Free Paper Forum: Podium 4

First Author: : E.Alfonso Muñoz SPAIN

Co Author(s): :    J. Davó-Cabrera   J. Piá-Ludeña   S. Montolio-Marzo   M. Hernández-Díaz   E. Fernández   C. Peris Martínez              

Abstract Details

Purpose:

Therapeutic keratoplasty (TK) is an emergency procedure in cases of uncontrollable infectious keratitis with high risk of perforation, severe corneal abscess or extracorneal spread of the infection. This study aimed to evaluate the long term anatomical, therapeutic and functional results of this technique.

Setting:

FISABIO Oftalmología Médica (FOM), Valencia, Spain.

Methods:

A retrospective review of the therapeutic keratoplasties (TK), due to uncontrollable infection, performed in our center from 2008 to 2018 with more than 1 year of follow-up is presented. Data analyzed include: age, gender, laterality, indication of TK, microorganisms identified at the anatomical pathology corneal buttons, follow-up time after the TK, control or not of the disease, secondary procedures, time of permanence of the TK until a new keratoplasty was done, preservation of the eye and final visual acuity (VA).

Results:

Twenty four TK of 23 patients were reviewed. There were 9 fungal, 3 amoebic, 1 herpetic, 9 bacterial and 2 mixed cases of keratitis. Microorganisms were detected in 14 anatomical pathology specimens. The mean follow-up time was 26 months. In 9 patients, after the TK, the infection was controlled. 19 patients needed more procedures. In uncontrolled cases the mean time between the first TK and the next keratoplasty was 4 months. 10 cases finished blind, in pthisis bulbi or evisceration. 5 cases had a final VA over 4/20. Acanthamoeba keratitis cases had a significantly better prognosis (p=0,014).

Conclusions:

TK is an emergency treatment with bad prognosis in most of the cases. In our series anatomical, therapeutic and functional success was obtained in 14 (58,3%), 9 (37,5%) and 5 (20,8%) cases respectively. Acanthamoeba keratitis cases, when indicated, are good candidates to TK with significantly better long term results compared to bacterial and fungal keratitis.

Financial Disclosure:

None