Outcomes of keratoplasty in a cohort of Pythium insidiosum keratitis cases at a tertiary eye care center in India.
Humans
India
/ epidemiology
Retrospective Studies
Male
Female
Tertiary Care Centers
Visual Acuity
Adult
Keratoplasty, Penetrating
/ methods
Middle Aged
Pythiosis
/ diagnosis
Keratitis
/ diagnosis
Graft Survival
Follow-Up Studies
Pythium
/ isolation & purification
Young Adult
Cornea
/ surgery
Treatment Outcome
Aged
Eye Infections, Parasitic
/ surgery
Adolescent
Journal
Indian journal of ophthalmology
ISSN: 1998-3689
Titre abrégé: Indian J Ophthalmol
Pays: India
ID NLM: 0405376
Informations de publication
Date de publication:
01 Aug 2024
01 Aug 2024
Historique:
received:
27
11
2023
accepted:
27
04
2024
medline:
30
7
2024
pubmed:
30
7
2024
entrez:
30
7
2024
Statut:
ppublish
Résumé
To assess outcomes of keratoplasty performed in patients diagnosed with keratitis caused by Pythium insidiosum (PI). Retrospective review. Preoperative, intra operative and post operative data of patients diagnosed with PI keratitis and who underwent keratoplasty for their condition from January 2020 to December 2021 were collected from the central patient database of a tertiary eye care hospital in India. The data were analyzed for anatomic success, elimination of infection, graft survival, incidence of repeat keratoplasty, final visual acuity and varied complications. In total, 16 eyes underwent penetrating keratoplasty for PI keratitis during the study period. Mean time to keratoplasty from onset of symptoms was 31.3 days and mean graft size was 10.4 mm. Nine out of the 16 cases had recurrence of infection following surgery, seven of which required a repeat keratoplasty for elimination of infection. Mean graft size for repeat keratoplasty performed in recurrent cases was 11.7 mm. Globe was successfully salvaged in 14 out of 16 patients (87.5 %). Three grafts remained clear at 6-month follow up while 11 grafts failed. Mean improvement in uncorrected visual acuity from 2.32 to 2.04 logMAR was observed at last follow up. Endo-exudates, graft infiltration, graft dehiscence, secondary glaucoma and retinal detachment were the various complications noted after keratoplasty. PI keratitis is a tenacious and potentially blinding condition. Keratoplasty remains the choice of treatment in this condition, however recurrence of disease and graft failure are common. Large sized grafts, meticulous per-operative removal of infection, adjuvant cryotherapy, and intraoperative and post operative use of antibiotics can help in improving outcome of keratoplasty in these patients.
Identifiants
pubmed: 39078955
doi: 10.4103/IJO.IJO_3108_23
pii: 02223307-202472080-00009
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1124-1129Informations de copyright
Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.
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