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Therapeutic keratoplasty effective for most infectious keratitis cases in study
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Therapeutic keratoplasty can effectively treat patients with severe, refractory infectious keratitis, although fungal keratitis can frequently recur, according to a study by researchers in Singapore.
Seng-Ei Ti, MD, and colleagues reviewed outcomes for 92 consecutive patients who underwent therapeutic keratoplasty between 1991 and 2002. All patients had presented with acute infectious keratitis and were treated at the Singapore National Eye Centre, according to the study.
Surgeons performed penetrating keratoplasty in 80 patients and lamellar keratoplasty in 12 patients, with grafts averaging 9.5 mm in diameter.
The researchers found that 74 of the 92 patients (80.4%) achieved therapeutic success after a single procedure and another three patients achieved success after undergoing a second keratoplasty. "Of the 15 patients for whom therapy failed, 11 had fungal keratitis," the authors said.
However, no significant differences in rates of therapeutic survival at 1 year were seen between patients treated for either bacterial or fungal keratitis. The 1-year survival rate was 76.6% for bacterial keratitis patients and 72.4% for fungal keratitis patients, according to the study.
However, 22 patients required a repeat keratoplasty procedure, including eight cases of optical regraft, seven cases of recurrence of the primary infection and seven cases of perforation or subsequent new infections.
Infections recurred between 4 days and 1 year after surgery, although 11 cases developed within 6 weeks postop, the authors noted.
The study is published in the May issue of American Journal of Ophthalmology.