Ficker L A, Kirkness C, Wright P
Moorfields Eye Hospital, London, United Kingdom.
Ophthalmology. 1993 Jan;100(1):105-10. doi: 10.1016/s0161-6420(93)31707-0.
Penetrating keratoplasty (PK) was undertaken between 1985-1991 at Moorfields Eye Hospital in 13 eyes (19 PKs) of 11 patients who developed Acanthamoeba keratitis. Infection was ultimately controlled in all cases. Retrospective analysis was undertaken to establish risk factors for PK. Six eyes were quiet and 7 had uncontrolled infection at the time of keratoplasty. The outcome for these was compared.
Complications included cataract in 50% of quiet eyes and 100% of inflamed eyes. Intumescent cataract resulted in glaucoma requiring drainage surgery in 4 eyes. Graft rejection episodes occurred in 50% of quiet eyes, but were treated aggressively and did not cause graft failure.
Graft survival was excellent for quiet eyes, but was compromised by recurrent infection in inflamed eyes and 6 patients were regrafted. Survival compared poorly with grafting for active herpetic or bacterial keratitis, indicating that early diagnosis and treatment are essential for adequate control of this disease.
1985年至1991年间，摩尔菲尔德眼科医院对11例患棘阿米巴角膜炎的患者的13只眼（19次穿透性角膜移植术）实施了穿透性角膜移植术。所有病例的感染最终均得到控制。进行回顾性分析以确定穿透性角膜移植术的危险因素。角膜移植时，6只眼情况稳定，7只眼存在未控制的感染。对二者的结果进行了比较。
并发症包括50%情况稳定的眼和100%有炎症的眼发生白内障。膨胀期白内障导致4只眼发生青光眼，需要进行引流手术。50%情况稳定的眼发生了移植排斥反应，但经积极治疗未导致移植失败。
情况稳定的眼的移植存活率良好，但有炎症的眼因反复感染而受到影响，6例患者接受了再次移植。与活动性疱疹性或细菌性角膜炎的移植相比，存活率较低，这表明早期诊断和治疗对于充分控制该病至关重要。
