Fungal keratitis requires surgery more often than other microbial infections

Indian J Ophthalmol. 2009;57(4):273-279.

Patients with fungal keratitis are at a higher risk of requiring surgical treatment than patients with other forms of keratitis, a long-term study of microbial keratitis in India found.

"While diagnostic and treatment modalities are well in place, the final outcome is suboptimal in fungal keratitis," researchers said. "With more effective treatment available for bacterial and Acanthamoeba keratitis, the treatment of fungal keratitis is truly a challenge."

The study authors retrospectively analyzed a non-comparative series of 5,897 cases of suspected microbial keratitis. Of those cases, 3,563 were culture-proven, showing 1,849 to have bacterial infections, 1,360 to have fungal infections, 86 to have Acanthamoeba infections and 268 to have mixed infections. Data were collected from a period of 10 years and 5 months at L.V. Prasad Eye Institute, Hyderabad, India.

According to the study, a significantly larger number of fungal keratitis cases needed surgical treatment, at 50.8%, compared with bacterial keratitis, at 43.2%, or Acanthamoeba keratitis, at 17.4%.

"Corneal healed scar was achieved in 75.5%, 64.8% and 90% of patients with bacterial, fungal and Acanthamoeba keratitis, respectively," the authors said.

They found that patients partaking in agricultural-based tasks were 1.33 times more likely of developing microbial keratitis. Also, ocular trauma posed a higher risk of developing microbial keratitis, with a 5.33 times greater risk.