https://scholars.lib.ntu.edu.tw/handle/123456789/517768
標題: | Therapeutic penetrating keratoplasty for microbial keratitis in Taiwan from 2001 to 2014 | 作者: | Tew T.B. HSIAO-SANG CHU YU-CHIH HOU WEI-LI CHEN I-JONG WANG FUNG-RONG HU |
公開日期: | 2020 | 卷: | 119 | 期: | 6 | 起(迄)頁: | 1061-1069 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Purpose: To study the surgical outcome of therapeutic penetrating keratoplasty (TPK) for medically uncontrolled microbial keratitis at a tertiary hospital in Taiwan over a 14-year period. Methods: This is a retrospective case series study. Patients who underwent TPK at National Taiwan University Hospital in 2001–2014 were included. Patients were divided into 3 diagnostic groups: bacterial keratitis, fungal keratitis, and acanthamoeba keratitis. Each of the following criteria was evaluated: graft clarity at 1 month and 1 year postoperatively, cure of the disease, and anatomical success rate. Results: A total of 107 TPKs were included. TPK eradicated the infection in 57/62 (91.9%) of bacterial keratitis, 33/41 (80.5%) of fungal keratitis, and 9/10 (90.0%) of acanthamoeba keratitis. 22/57 grafts (38.6%) of bacterial keratitis, 22/38 grafts (57.9%) of fungal keratitis, and 5/10 grafts (50.0%) of acanthamoeba keratitis remained clear at 1 year postoperatively. The 1-year graft survival rate did not significantly differ among these 3 groups. The leading causes of graft failure were late endothelial decompensation and graft reinfection. A higher percentage of graft clarity was achieved in grafts <8.5 mm in diameter than in larger grafts (55.4% vs. 31.4%, P = 0.027). Of the 14 patients with endophthalmitis at the time of TPK, the infection was successfully treated in 13 patients except 1 patient required evisceration. Conclusion: TPK is valuable in the management of medically uncontrolled microbial keratitis, although the 1-year graft survival rate is unsatisfactory. TPK combined with intravitreal antibiotics and vitrectomy is also a beneficial treatment strategy for patients with endophthalmitis secondary to microbial keratitis. ? 2019 Formosan Medical Association |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85084819661&doi=10.1016%2fj.jfma.2019.09.016&partnerID=40&md5=d165266df944fba25067751a27b95323 https://scholars.lib.ntu.edu.tw/handle/123456789/517768 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2019.09.016 | SDG/關鍵字: | ceftazidime; vancomycin; voriconazole; Acanthamoeba keratitis; adult; aged; Article; bacterial keratitis; best corrected visual acuity; controlled study; disease association; disease predisposition; endophthalmitis; female; follow up; graft failure; graft survival; human; keratomycosis; major clinical study; male; medical record; microbial keratitis; middle aged; nonhuman; outcome assessment; penetrating keratoplasty; postoperative period; Pseudomonas aeruginosa; retrospective study; risk factor; slit lamp microscopy; Staphylococcus; surgical patient; Taiwan; tertiary care center; very elderly; young adult; cornea ulcer; epidemiology; keratitis; microbiology; visual acuity; Corneal Ulcer; Humans; Keratitis; Keratoplasty, Penetrating; Retrospective Studies; Taiwan; Visual Acuity |
顯示於: | 醫學系 |
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