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Sequential therapeutic PK advantageous in management of severe infectious keratitis
Sequential therapeutic penetrating keratoplasty was an effective solution for the management of severe infectious keratitis, a study found.
The surgical technique involved using a cryopreserved cornea for a designated interval before performing a graft exchange with a fresh optical-grade cornea.
The retrospective case-control study included 32 eyes of 32 patients who underwent sequential therapeutic PK for active severe infectious keratitis unresponsive to maximal medical therapy between 2003 and 2009 at the Singapore National Eye Centre. Ten of the patients underwent sequential therapeutic PK while the remaining 22 served as age- and sex-matched controls. The mean interval between graft exchanges was 16.8 days.
Each sequential therapeutic PK case achieved therapeutic success, defined as the eradication of the primary infection; however, only 13 controls achieved the same. The difference was statistically significant (P = .06).
Sequential therapeutic PK also showed statistically significantly better graft survival at 1 year (72.9% vs. 53.8%) and Snellen acuity by at least two lines (80% vs. 14%).
“These studies may be possible in less developed countries where infectious keratitis remains a major indication for transplantation and where donor shortage is prevalent,” the study authors said.
Use of sequential therapeutic PK will also conserve optical-grade corneal tissue, they said.