medigraphic.com
ISSN 1561-3070 (Electronic)

2013, Number 3

<< Back Next >>

Rev Cub Oftal 2013; 26 (3)

Clinical and epidemiological characteristics of infectious keratitis in patients operated on by optic penetrating keratoplasty

Castro CK, López HSM, Rodríguez RD, Tápanes FT, Hormigó PI, Perea CA

Language: Spanish
References: 24
Page: 379-389
PDF size: 343.64 Kb.


ABSTRACT

Objective: To describe the clinical and epidemiological characteristics of infectious keratitis in optic penetrating keratoplasty.
Methods: Prospective, longitudinal, descriptive and observational research of a sample of 31 patients diagnosed with infectious ketatitis in their corneal graft, after undergoing optic penetrating keratoplasty. They had been attended to in the Corneal Service of "Ramon Pando Ferrer" Cuban Institute of Ophthalmology from March to November 2010. The studied variables were age, sex, time lapse from the penetrating keratoplasty to the starting of infection, predisposing factors associated to infectious keratitis, clinical manifestations, complications and final condition of the graft.
Results: Males (61.3%) and 30-44 y age group (45.2%) were predominant. The majority of cases presented with late infection, being the use of topical steroids the main predisposing factor. The most frequent symptom was secretion (77.4%) and the most significant sign was corneal edema (74.1%). Peripheral location of infiltrates (51.6%) predominated, with size of 1-3 mm (48.4%) and depth up to the anterior third (58.1%). The most common complication was secondary ocular hypertension (50%). The graft kept transparency just in 12.9% of patients.
Conclusions: Microbial keratitis after corneal transplantation is a threatening complication for the vision and may lead to loss of transparency due to formation of corneal scar. It is necessary to keep control over the predisposing factors to reduce the frequency of this complication.


REFERENCES

  1. Biswell R. Cornea. En: Riordan-Eva P, Whitcher JP. Vaughan Asbury´s General Ophthalmology. 16 ed. New York: Lange Medical Books/MacGraw-Hill; 2004. p. 129-53.

  2. Charlín R, López M. Transplante corneal: análisis retrospectivo de una serie nacional. Arch Chil Oftalmol. 2004;61(2):13-20.

  3. Santiesteban Freixas R. Historia de la Oftalmología en Cuba. 2da ed. La Habana: Editorial Ciencias Médicas; 2006.

  4. Zirm EK. Eine Erfolgreiche Totales Keratoplastik (A successful total keratoplasty). 1906. Refract Corneal Surg. 1989;5(4):258-61.

  5. Lindquist TD, Mcneill JI, Wilhelmus KR. Indication for keratoplastic. Cornea. 1994;13(2):105-7.

  6. López M. Comportamiento clínico de los casos de Queratoplastias Penetrantes Realizados en Centro Nacional de Oftalmología de enero 2006- marzo 2008 [tesis]. Universidad Nacional Autónoma de Nicaragua; 2008.

  7. Eguía F, Rio M, Capote A. Manual de diagnóstico y tratamiento en Oftalmología. La Habana: Editorial Ciencias Médicas; 2009.

  8. Dobbing KR, Price FW Jr, Whitson WE. Trend in the indications for penetrating keratoplasty in the Midwestern United States. Cornea. 2000;19(6):813-6.

  9. Sharma N, Vajpayee RB. Corneal ulcers. Diagnosis and management. New Delhi: Jaypee Brothers; 2008.

  10. Devi J. Adelantos recientes en diagnóstico y tratamiento de queratitis bacteriana. International Ophthalmology Clinics. 2007;47(3):1-6.

  11. American Academy of Ophthalmology. External Disease and Cornea. USA: American Academy of Ophthalmology; 2008. (Basic and Clinical Science Course)

  12. Akova YA, Onat M, Koc F, Nurozler A, Duman S. Microbial queratitis after penetrating keratoplasty. Ophthalmic Surgery and Lasers. 1999;30(6):449-55.

  13. Tseng SH, Ling KC. Late microbial keratitis after corneal transplantation. Cornea 1995;14(6):591-4.

  14. Sánchez A, Bueno J, Brito C, Fernández FJ, Melcon B, Pueyo M, et al. Estudio de la queratitis infecciosa en el injerto corneal. Arch Soc Esp Oftalmol. [citado 15 de oct de 2010]. 2000;75(10):[aprox 13 p.]. Disponible en: http://www.oftalmo.com/seo/archivos /maquetas/E/77D5F391-0F81-4609-9A44- 000049313EFE/articulo.html

  15. Sonavane A, Sharma S, Gangopadhyay N, Bansal AK. Clinico-microbiological Correlation of Suture-related Graft Infection Following Penetrating Keratoplasty. American Journal of Ophthalmology. 2003;135(1):89-91.

  16. De la Torre A, Núñez MX, Blanco C. Guías de manejo de las queratitis infecciosas bacterianas. Hospital Universitario del Valle, enero-julio 2002; 2003.

  17. Serrano-Calderon C, Hernández G, Gómez A, Castillo CA. Perfil epidemiológico, clínico y microbiológico de las ulceras corneales en el Departamento de Segmento Anterior de la Fundación Oftalmológica de Santander. MedUNAB. 2007;10(2):93-8.

  18. Akova YA, Onat M, Koc F, Nurozler A, Duman S. Microbial keratitis following penetrating keratoplasty. Ophthalmic Surg Lasers. 1999;30(6):449-55.

  19. Harris DJ Jr, tulting RD, Wilson LA. Late bacterial and fungal keratitis after corneal transplantation. Spectrum of pathogens, graft survival, and visual prognosis. Ophthalmology. 1988; 95(10):1450-7.

  20. Vajpayee RB, Sharma N, Sinha R, Agarwal T, Singhyi Arun. Infectious keratitis following keratoplasty. Saudi Journal of Ophthalmology. 2007;52(1):1-12.

  21. Nicola F. Queratitis infecciosa no viral: factores predisponentes, agentes etiológicos y diagnóstico de laboratorio. Rev Argent Microbiol. 2005;37(4):229-39.

  22. Siganos CS, Solomon A, Frucht-Pery J. Microbial findings in suture erosion after penetrating keratoplasty. Ophthalmology. 1997;104(3):513-6.

  23. Gómez Castillo Z, López Hernández S, Castillo Pérez AC, Rodríguez de Paz U, Pérez Parra Z, et al. Microscopia confocal en operados de queratoplastia perforante. Rev Cubana Oftalmol. 2009 Jun [citado 2010 oct 11];22(1):[aprox 12 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864- 21762009000100006&lng=es

  24. Vajpayee RB, Boral SK, Dada T, Murthy GV, Pandey RM, Satpathy G. Risk factors for graft infection in India: a case-control study. Br J Ophthalmol. 2002;86(3):261-5.




2020     |     www.medigraphic.com