Cornea & Refractive Surgery Services, 75838Dr Shroff's Charity Eye Hospital, New Delhi, India.
Lab Services, 75838Dr Shroff's Charity Eye Hospital, New Delhi, India.
Eur J Ophthalmol. 2022 Sep;32(5):2652-2661. doi: 10.1177/11206721211062979. Epub 2021 Nov 23.
To study the clinico-microbiological profile, outcomes and prognostic factors of post penetrating keratoplasty (PKP) infectious keratitis.
Retrospective review of medical records of 78 patients with post PKP infectious keratitis presenting between January 2014 and December 2018. Demographic, clinical and microbiological profile was documented and predictors of treatment and graft success were evaluated using univariate and subsequent multivariate logistic regression analysis.
Mean age of patients was 52.17 ± 15.51 years and mean infiltrate size was 19.39 ± 19.68 mm. Mean duration of presentation with infection post PKP was 11.66 ± 10.65 months. Culture positivity was seen in 64 eyes (82.05%). Bacterial growth was observed in 47 eyes (60.25%), fungal growth in 17 (21.79%) and no microbiological growth in 14 eyes (17.94%). At 3 months the visual acuity (VA) improved in 37 eyes (47.44%), did not change in 27 (34.62%) and deteriorated in 14 (17.95%). Graft failure was noted in 53 eyes (73.08%). Surgical intervention was needed in 47 (60.25%) eyes of which most common was therapeutic PKP in 32 eyes (41.02%). Treatment failure was noted with fungal infection ( = 0.05), poorer vision at presentation ( = 0.02), larger infiltrate area ( = 0.002) and graft infection developing before 1 year ( = 0.02). Graft failure was noted with associated endophthalmitis ( = 0.02), poorer VA at presentation ( = 0.01) and larger infiltrate area ( = 0.02).
Post PKP infectious keratitis is a sight threatening ocular condition. It is associated with high incidence of graft failure and frequently requires surgical intervention. Fungal etiology, larger infiltrate size, poorer vision at presentation and associated endophthalmitis carries a poorer prognosis.
研究穿透性角膜移植术后（PKP）感染性角膜炎的临床微生物学特征、结局和预后因素。
回顾性分析 2014 年 1 月至 2018 年 12 月期间 78 例 PKP 后感染性角膜炎患者的病历。记录患者的人口统计学、临床和微生物学特征，并采用单变量和随后的多变量逻辑回归分析评估治疗和移植物成功的预测因素。
患者的平均年龄为 52.17±15.51 岁，平均浸润面积为 19.39±19.68mm。感染后出现 PKP 的平均时间为 11.66±10.65 个月。64 只眼（82.05%）培养阳性。47 只眼（60.25%）观察到细菌生长，17 只眼（21.79%）真菌生长，14 只眼（17.94%）无微生物生长。3 个月时，37 只眼（47.44%）视力改善，27 只眼（34.62%）视力无变化，14 只眼（17.95%）视力恶化。53 只眼（73.08%）发生移植失败。47 只眼（60.25%）需要手术干预，其中最常见的是 32 只眼（41.02%）行治疗性穿透性角膜移植术。真菌感染（ = 0.05）、就诊时视力较差（ = 0.02）、浸润面积较大（ = 0.002）和 1 年内发生移植物感染（ = 0.02）与治疗失败有关。合并眼内炎（ = 0.02）、就诊时视力较差（ = 0.01）和浸润面积较大（ = 0.02）与移植物失败有关。
PKP 后感染性角膜炎是一种威胁视力的眼部疾病。它常伴有较高的移植物失败率，并且经常需要手术干预。真菌感染、较大的浸润面积、就诊时视力较差和合并眼内炎预示着预后较差。
