Yilmaz Yusuf Cem, Hayat Serife Ciloglu, Bilgin Gizem Sayar, Altinkurt Emre
Department of Ophthalmology, University of Health Sciences, Cam and Sakura City Hospital, Istanbul, Türkiye.
Department of Ophthalmology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Türkiye.
Beyoglu Eye J. 2024 Jun 1;9(2):61-68. doi: 10.14744/bej.2024.69772. eCollection 2024.
It was aimed to to provide a comprehensive assessment of therapeutic and tectonic emergency keratoplasty procedures, along with a discussion on their indications, prognostic factors for functional success, and postoperative outcomes.
Patients who underwent therapeutic or tectonic Penetrating Keratoplasty (PKP) procedures between 2010 to 2021 in our hospital were retrospectively reviewed. Patient files were evaluated in terms of demographic characteristics, medical and ocular history, visual acuity, initial ocular findings, presence of glaucoma, causative microorganisms, details of surgical procedures, complications, graft transparency and globe integrity. Visual acuity was measured as light perception, hand motion, counting finger, Snellen chart and subsequently converted to Logarithm of the Minimum Angle of Resolution (logMAR) for statistical analysis.
The study included a total of 43 patients, with 16 (37.2%) being female. The average age of the participants was 59.72±18.1 years. The corrected distance visual acuity improved from 2.3±0.66 logMAR preoperatively to 1.72±1.02 logMAR postoperatively (p=0.001). After PKP, anatomical success was achieved in all eyes and functional success was achieved in 23 (51.1%) eyes. It was observed that only preoperative glaucoma had a significant impact on graft survival rate (p=0.002, Figure 2), as well as functional success (p=0.022).
Urgent keratoplasty is a viable treatment option for cases involving an actively uncontrolled infection or corneal disease with perforation. In cases of graft rejection, bacteria, fungi, and viral pathogens were detected as causative agents, whereas only bacteria were detected as the causative agents in cases of pre and post-operative endophthalmitis. Early diagnosis and treatment play crucial roles in achieving anatomical and functional success.
旨在对治疗性和结构性急诊角膜移植手术进行全面评估，并讨论其适应症、功能成功的预后因素及术后结果。
对2010年至2021年期间在我院接受治疗性或结构性穿透性角膜移植术（PKP）的患者进行回顾性研究。评估患者档案中的人口统计学特征、病史和眼部病史、视力、初始眼部检查结果、青光眼的存在情况、致病微生物、手术细节、并发症、植片透明度和眼球完整性。视力测量为光感、手动、数指、Snellen视力表，随后转换为最小分辨角对数（logMAR）进行统计分析。
该研究共纳入43例患者，其中女性16例（37.2%）。参与者的平均年龄为59.72±18.1岁。矫正远视力从术前的2.3±0.66 logMAR提高到术后的1.72±1.02 logMAR（p=0.001）。PKP术后，所有术眼均获得解剖学成功，23只眼（51.1%）获得功能成功。观察发现，只有术前青光眼对植片存活率（p=0.002，图2）以及功能成功（p=0.022）有显著影响。
紧急角膜移植是治疗活动性感染未得到控制或角膜疾病伴穿孔病例的可行治疗选择。在移植排斥病例中，检测到细菌、真菌和病毒病原体为致病因子，而在术前和术后眼内炎病例中，仅检测到细菌为致病因子。早期诊断和治疗对实现解剖学和功能成功起着关键作用。
