Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Ophthalmology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Sci Rep. 2016 Sep 2;6:32751. doi: 10.1038/srep32751.
Infectious keratitis after penetrating keratoplasty (PK) is a devastating condition that may result in graft failure and poor visual outcome. In this study, we retrospectively reviewed the medical records of patients who underwent PK between 2009 and 2014, and recorded those who developed infectious keratitis. We compared the predisposing factors and organisms isolated to those identified in our previous study, conducted between 1989 and 1994. The incidence of post-PK infectious keratitis decreased from 11.6% (41 out of 354 cases, 1989-1994) to 6.5% (9 out of 138 cases, 2009-2014). Graft epithelial defect and suture-related problems remained the leading two risk factors of infectious keratitis after PK. Gram-positive and Gram-negative bacterial infection decreased from 58.5% and 46.3% to 11.1% and 22.2%, respectively (P = 0.023 and P = 0.271). In contrast, fungus infection increased from 9.8% to 66.7% (P = 0.001); fungi have become the major pathogen for post-PK infectious keratitis. In conclusion, while the incidence of post-PK infectious keratitis has decreased over time, the number and frequency of fungal infections have significantly increased in the recent study period. Clinicians should be aware of the shifting trend in pathogens involved in post-PK infectious keratitis.
穿透性角膜移植术后感染性角膜炎是一种破坏性疾病，可导致移植物失败和视力预后不良。本研究回顾性分析了 2009 年至 2014 年间接受穿透性角膜移植术的患者的病历，并记录了发生感染性角膜炎的患者。我们比较了两组患者的易患因素和分离出的病原体，与我们之前在 1989 年至 1994 年期间进行的研究进行了比较。穿透性角膜移植术后感染性角膜炎的发生率从 11.6%（41/354 例，1989-1994 年）降至 6.5%（9/138 例，2009-2014 年）。移植片上皮缺损和缝线相关问题仍然是穿透性角膜移植术后感染性角膜炎的两个主要危险因素。革兰阳性和革兰阴性细菌感染从 58.5%和 46.3%分别降至 11.1%和 22.2%（P=0.023 和 P=0.271）。相比之下，真菌感染从 9.8%增加到 66.7%（P=0.001）；真菌已成为穿透性角膜移植术后感染性角膜炎的主要病原体。总之，虽然穿透性角膜移植术后感染性角膜炎的发生率随时间推移呈下降趋势，但在最近的研究期间，真菌感染的数量和频率显著增加。临床医生应注意与穿透性角膜移植术后感染性角膜炎相关的病原体变化趋势。
