scholarly journals Assessment of Clinical Outcome Following Therapeutic Penetrating Keratoplasty in Non-Healing Infective and Perforated Corneal Ulcer

2021 ◽  
Vol 10 (43) ◽  
pp. 3670-3675
Author(s):  
Suria Rashmi C. ◽  
Gajaraj Tulsidas Naik ◽  
Satish K. ◽  
Meghana Neeralgi ◽  
Mohamed Abdul Kayoom ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Penetrating Keratoplasty ◽  
Structural Integrity ◽  
Corneal Ulcer ◽  
Visual Outcome ◽  
Visual Disability ◽  
Tissue Quality ◽  
Corneal Ulcers ◽  
Corneal Blindness ◽  
Therapeutic Penetrating Keratoplasty

BACKGROUND Corneal blindness has been a significant visual disability in developing countries like India. Corneal ulcer contributes mainly as the leading cause for monocular blindness. Considering the common condition, the studies and literature have been surprisingly less when it comes to corneal ulcer and their management. But with the advent of therapeutic penetrating keratoplasty (TPK), the scenario and prevalence of corneal blindness can be reduced. Hence this study was done to know the importance of therapeutic penetrating keratoplasty in case of non-healing infective and perforated corneal ulcers. The objectives were to assess the clinical outcome in a non-healing and perforated corneal ulcer, reduction in symptoms and signs of infection, anatomical or structural integrity of the globe and also evaluate the visual outcome following therapeutic penetrating keratoplasty. METHODS Data were obtained from 30 patients operated at our institute for therapeutic penetrating keratoplasty. Patients with less than one year of follow up, paediatric cases, PL negative cases were excluded. The outcome was assessed based on maintenance of structural integrity, reduction in infective load, improvement in visual acuity and graft survival and its correlation with corneal vascularisation, previously failed grafts, donor tissue quality, graft size and type of surgery. RESULTS Structural integrity was maintained in 93.3 % of the cases, reduction of infective load in 90 % of cases and optically clear grafts in 46.7 % of cases and vision was better than 6/60 in 30 % of cases. CONCLUSIONS The study proved that in the case of non-healing and perforated corneal ulcers, therapeutic penetrating keratoplasty had a good prognosis in reducing infective load, maintaining structural integrity without which eye could have been lost. KEYWORDS Therapeutic Penetrating keratoplasty, Perforated corneal ulcer, non-healing corneal ulcer, corneal blindness, TPK

Therapeutic Penetrating Keratoplasty in Nonhealing Corneal Ulcer

1995 ◽  
Vol 26 (4) ◽  
pp. 325-329
Author(s):  
Anita Panda ◽  
Sudarshan Khokhar ◽  
Venkateshwar Rao ◽  
Gopal Krushna Das ◽  
Namrata Sharma
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Ulcer ◽  
Therapeutic Penetrating Keratoplasty

Therapeutic penetrating keratoplasty for infectious and non-infectious corneal ulcers

2014 ◽  
Vol 35 (2) ◽  
pp. 193-200 ◽  
Author(s):  
Zuleyha Yalniz-Akkaya ◽  
Ayse Burcu ◽  
Emine Doğan ◽  
Mustafa Onat ◽  
Firdevs Ornek
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Ulcers ◽  
Therapeutic Penetrating Keratoplasty

scholarly journals Pythium keratitis: clinical course of an emerging scourge

2020 ◽  
Vol 17 (3) ◽  
pp. 318-323
Author(s):  
Radhika Natarajan ◽  
Ankit Anil Harwani ◽  
Ramya Ravindran
Keyword(s):  
Polymerase Chain Reaction ◽  
Confocal Microscopy ◽  
Penetrating Keratoplasty ◽  
Clinical Presentation ◽  
Corneal Ulcer ◽  
Clinical Course ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Therapeutic Penetrating Keratoplasty

We hereby report two cases of the emerging and devastating Pythium keratitis for their different presentations, prolonged clinical course, and suspicion of recurrence after therapeutic penetrating keratoplasty (TPK). The history, clinical presentation, investigations including smears, cultures, polymerase chain reaction (PCR) and confocal microscopy, the tumultuous course of the infection, and outcome of TPK have been discussed for two cases having this unusual and severe emerging infection. These two cases demonstrate that Pythium keratitis can present as a central reticular or peripheral guttering corneal ulcer with dense infiltration. PCR is a valuable tool for diagnosis. Pythium keratitis has a severe and prolonged clinical course. Response to antibiotics is modest and needs to be closely monitored. It can present with inflammation after TPK that mimics the dreaded recurrence of the infection. Pythium keratitis presents variably and can be suspected from typical clinical and microbiological findings. It needs protracted treatment with close follow-up. Although the infection is known torecur in the therapeutic graft, not all recurrences are what they seem.

scholarly journals Corneal Phaeohyphomycosis Caused by Bipolaris hawaiiensis

2016 ◽  
Vol 7 (2) ◽  
pp. 364-371 ◽  
Author(s):  
Winai Chaidaroon ◽  
Sumet Supalaset ◽  
Napaporn Tananuvat ◽  
Nongnuch Vanittanakom
Keyword(s):  
Fungal Infection ◽  
Penetrating Keratoplasty ◽  
Corneal Ulcer ◽  
Nucleotide Sequence Analysis ◽  
Laboratory Findings ◽  
History Of ◽  
Oral Itraconazole ◽  
Eye Examination ◽  
Diagnostic Clue ◽  
Therapeutic Penetrating Keratoplasty

Purpose: To report a rare case of keratitis infected by Bipolaris hawaiiensis. Methods: A patient who was diagnosed as fungal keratitis caused by B. hawaiiensis was retrospectively reviewed for history, clinical characteristics, risk factors, laboratory findings, treatments, and outcomes. Results: A 63-year-old man with a history of trauma and saw dust in the left eye presented with a corneal ulcer. Eye examination revealed whitish infiltration with a feathery edge and small brownish deposits in the anterior stroma of the left cornea. Numerous septate hyphal fragments were detected in a corneal specimen, and nucleotide sequence analysis identified B. hawaiiensis. Treatment was started with 5% natamycin eyedrops and oral itraconazole. Subsequently, a corneal plaque developed which did not respond to medication and debridement. The patient underwent therapeutic penetrating keratoplasty. Conclusions: B. hawaiiensis is a rare cause of corneal phaeohyphomycosis. A brownish pigmented infiltration is an important diagnostic clue, however microbiologic studies are required to obtain a definite diagnosis. Although antifungal medication and debridement are the mainstay of most corneal fungal infection, therapeutic penetrating keratoplasty can prevent morbidity related to this fungal infection.

scholarly journals Outcomes of Infectious versus Sterile Perforated Corneal Ulcers after Therapeutic Penetrating Keratoplasty in the United States

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sloan W. Rush ◽  
Ryan B. Rush
Keyword(s):  
United States ◽  
Penetrating Keratoplasty ◽  
The United States ◽  
Underlying Disease ◽  
Corneal Ulcers ◽  
Surgical Measures ◽  
Disease Condition ◽  
Therapeutic Penetrating Keratoplasty

Purpose. To compare the long-term outcomes of infectious versus sterile perforated corneal ulcers after therapeutic penetrating keratoplasty in the United States.Methods. The charts of 45 consecutive eyes that underwent primary therapeutic penetrating keratoplasty for a perforated corneal ulcer at a single center were retrospectively reviewed. The perforated ulcers were classified as infectious or sterile and the underlying demographics, clinical features, and 36-month outcomes were compared among the two groups.Results.Mean follow-up among subjects was 38.6 (±6.9) months. Patients presenting with sterile perforated ulcers were more likely to have a peripheral perforation location (p=0.0333) and recurrence of the underlying disease condition (p=0.0321), require adjunctive surgical measures in the immediate postoperative period (p<0.0001), have reperforation after keratoplasty (p=0.0079), have worse best corrected visual acuity (p=0.0130), develop no light perception vision (p=0.0053), and require enucleation/evisceration (p=0.0252) when compared to the infectious perforated ulcer group.Conclusions. Sterile perforated corneal ulcers have a worse prognosis and may be more frequent than those caused by infectious disease in the United States compared to the developing world.

scholarly journals Visual Outcome of Keratoplasty on Vascularised Cornea- A Prospective Study

2017 ◽  
Vol 28 (2) ◽  
pp. 69-71
Author(s):  
Md Shariful Islam Bhuiya
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Ulcer ◽  
Economic Status ◽  
Visual Outcome ◽  
Corneal Opacity ◽  
College Hospital ◽  
Male Predominance ◽  
Before And After ◽  
Medicine Today ◽  
A Prospective Study

One of the leading causes of blindness is corneal disorder. By keratoplasty we can restore vision of those patients to some extent and many surgeons are performing keratoplasty on vascularised cornea. Present study was done to evaluate its outcome. Patients (5-70 yrs) were recruited from eye ward of Dhaka Medical College Hospital from January, 2007 to December, 2007. Patients were selected on some criteria. Total 33 cases were evaluated before and after operation. This study was carried out to know pattern of blindness and to obtain the causes of corneal vascularisation and results of keratoplasty on these patients. Among 2 types of grafting all our patients were undergone penetrating keratoplasty. Male predominance (57.50) was marked as male are more prone to corneal diseases and trauma. Considering age group nobody is immune from corneal disease but children and young persons are more vulnerable. Socio-economic status of our maximum patients are middle-class or poor class. We got a rough idea about the causes leading to vascularisation of cornea. Amongst them; trauma, corneal ulcer, chemical injury and under nutrition are noted in our study. Out of 33 healthy grafts, visual improvement occurred in 24 cases. Visual results of grafting on vascularised corneas are variable. Our study concludes that trauma and corneal ulcer are the leading causes of corneal opacity which need penetrating keratoplasty. Whatever the cause of corneal vascularisation, prognosis of keratoplasty on such cases is not disappointing. Rather keratoplasty done on early notified corneal opacity with superficial vascularisation gives satisfactory results .Medicine Today 2016 Vol.28(2): 69-71

scholarly journals Use of Plasma Rich in Growth Factors and ReGeneraTing Agent Matrix for the Treatment of Corneal Diseases

Vision ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 34
Author(s):  
Ronald M. Sánchez-Ávila ◽  
Edmar Uribe-Badillo ◽  
Carlos Fernández-Vega González ◽  
Francisco Muruzabal ◽  
Borja de la Sen-Corcuera ◽  
...  
Keyword(s):  
Growth Factors ◽  
Corneal Ulcer ◽  
Disease Index ◽  
Eye Drops ◽  
Analog Scale ◽  
Ocular Surface Disease Index ◽  
Corneal Ulcers ◽  
Corrected Visual Acuity ◽  
The Mean

This study aimed to investigate the use of Plasma Rich in Growth Factors (PRGF) associated with tissue ReGeneraTing Agent (RGTA) drops for the treatment of noninfectious corneal ulcers. RGTA treatment was applied (one drop every two days); however, if ulcer closure was not achieved, PRGF eye drops treatment was added (four times/day). The time taken to reach the ulcer closure, the Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), Visual Analog Scale (VAS, in terms of frequency and severity of symptoms), and Ocular Surface Disease Index (OSDI) were evaluated. Seventy-four patients (79 eyes) were included, and the mean age was 56.8 ± 17.3 years. The neurotrophic corneal ulcer was the most frequent disorder (n = 27, 34.2%), mainly for herpes virus (n = 15, 19.0%). The time of PRGF eye drops treatment associated with the RGTA matrix was 4.2 ± 2.2 (1.5–9.0) months, and the follow-up period was 44.9 ± 31.5 months. The ulcer closure was achieved in 76 eyes (96.2%). BCVA, VAS and OSDI improved from the baseline (p < 0.001), and IOP remained unchanged (p = 0.665). RGTA and PRGF in noninfectious ulcers were effective and could be a therapeutic alternative for this type of corneal disease.

Suprasellar meningiomas: the effect of tumor location on postoperative visual outcome

1988 ◽  
Vol 69 (4) ◽  
pp. 523-528 ◽  
Author(s):  
Brian T. Andrews ◽  
Charles B. Wilson
Keyword(s):  
Visual Loss ◽  
Visual Outcome ◽  
Tumor Location ◽  
Postoperative Recovery ◽  
Optic Canal ◽  
Visual Disability ◽  
Content Type ◽  
Tuberculum Sellae ◽  
Diaphragma Sellae ◽  
Planum Sphenoidale

✓ The authors reviewed 38 cases of suprasellar meningioma to determine the correlation between tumor site and postoperative visual outcome. Progressive visual loss, the most frequent initial complaint (94.7%), occurred over a mean of 24½ months, was most often unilateral (18 patients) or bilateral but asymmetrical (14 patients), and was severe (20/200 vision or worse) in 23 patients; 24 patients had visual field abnormalities. Computerized tomography or magnetic resonance studies clearly delineated the lesions but did not appear to permit earlier diagnosis. Eleven patients had tumors limited to the tuberculum sellae; the tumor extended from the tuberculum sellae onto the planum sphenoidale in nine patients, into one optic canal in eight, onto the diaphragma sellae in seven, and onto the medial sphenoid wing in three. Patients with tumors affecting the optic canal had severe unilateral visual loss more often than those with tumors at other sites. Tumors limited to the tuberculum sellae were most often completely resected; postoperative recovery of vision was also most frequent in patients with tumors at this site. Tumors involving the diaphragma sellae or the medial sphenoid wing were least often completely removed and most likely to be associated with postoperative visual deterioration. Overall, 42% of patients had improved vision postoperatively, 30% remained unchanged, and 28% were worse. After a mean follow-up period of 38 months, 24 patients are doing well, four have significant visual disability, and three are blind or doing poorly. Two patients died of causes unrelated to their tumor. Three patients have had tumor recurrence.

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