Yusuf Koçluk1, Emine Alyamaç Sukgen2. 1. Eye Department, Adana Numune Training and Research Hospital, Serinevler Mah. Ege Bağatur Bulvarı Üzeri, Yüreğir, Adana, Turkey. kocluk99@gmail.com. 2. Eye Department, Adana Numune Training and Research Hospital, Serinevler Mah. Ege Bağatur Bulvarı Üzeri, Yüreğir, Adana, Turkey.
Abstract
PURPOSE: This study aimed to report the results of therapeutic penetrating keratoplasty (TPKP) performed at early and late stage of keratitis. METHODS: The study involved patients who underwent TPKP surgery due to bacterial, fungal, or mixed (bacterial and fungal) keratitis. The patients were divided into two groups. Group 1 (13 patients) was the patients operated at early stage of corneal abscess formation or in 15 days after the start of keratitis and group 2 (12 patients) was the patients operated at late stage of keratitis or after at least 15 days after the initial appearance of symptoms. Preoperative clinical signs and postoperative results were presented. RESULTS: At the end of the follow-up period, 13 (100 %) of grafts in the early TPKP group and 10 (83.3 %) of grafts in the late TPKP group remained clear (p = 0.125). Recurrence of infection at last visit after TPKP was 0 (0 %) of cases in group 1, and was 2 (16.7 %) of cases in group 2 (p = 0.125) Therapeutic success was achieved and the eyes were preserved in 23 patients of both groups. Evisceration was performed for a case and phthisis bulbi was seen in a case in group 2. The groups were statistically different regarding the presence of postoperative complications (p = 0.015). CONCLUSION: TPKP performed in cases that do not respond medical treatment, in the early phase of the disease, before the lesions reach to limbus and without waiting corneal perforation, may yield better clinical results and less postoperative complications.
PURPOSE: This study aimed to report the results of therapeutic penetrating keratoplasty (TPKP) performed at early and late stage of keratitis. METHODS: The study involved patients who underwent TPKP surgery due to bacterial, fungal, or mixed (bacterial and fungal) keratitis. The patients were divided into two groups. Group 1 (13 patients) was the patients operated at early stage of corneal abscess formation or in 15 days after the start of keratitis and group 2 (12 patients) was the patients operated at late stage of keratitis or after at least 15 days after the initial appearance of symptoms. Preoperative clinical signs and postoperative results were presented. RESULTS: At the end of the follow-up period, 13 (100 %) of grafts in the early TPKP group and 10 (83.3 %) of grafts in the late TPKP group remained clear (p = 0.125). Recurrence of infection at last visit after TPKP was 0 (0 %) of cases in group 1, and was 2 (16.7 %) of cases in group 2 (p = 0.125) Therapeutic success was achieved and the eyes were preserved in 23 patients of both groups. Evisceration was performed for a case and phthisis bulbi was seen in a case in group 2. The groups were statistically different regarding the presence of postoperative complications (p = 0.015). CONCLUSION: TPKP performed in cases that do not respond medical treatment, in the early phase of the disease, before the lesions reach to limbus and without waiting corneal perforation, may yield better clinical results and less postoperative complications.
Authors: N Venkatesh Prajna; Tiruvengada Krishnan; Revathi Rajaraman; Sushila Patel; Ranjeet Shah; Muthiah Srinivasan; Manoranjan Das; Kathryn J Ray; Catherine E Oldenburg; Stephen D McLeod; Michael E Zegans; Nisha R Acharya; Thomas M Lietman; Jennifer Rose-Nussbaumer Journal: JAMA Ophthalmol Date: 2017-09-01 Impact factor: 7.389