Effect of corneal graft diameter on therapeutic penetrating keratoplasty for fungal keratitis.

AIM To evaluate the effect of corneal graft diameter on therapeutic penetrating keratoplasty (PKP) for fungal keratitis. METHODS A total of 116 patients (116 eyes) suffered from fungal keratitis underwent PKP at the Affiliated Hospital of Medical College Qingdao University from May 2006 to May 2010. They were divided into two groups according to the corneal graft diameter. 64 eyes' corneal graft diameter was 8.00mm or larger and 52 eyes' graft diameter was smaller than 8.00mm. The follow-up time was 2 years. The postoperative visual acuity and complications were documented and compared. RESULTS Sixty-two (96.88%) eyes and fifty (96.15%) eyes preserved eyeballs respectively in two groups. There was no statistical difference in postoperative visual acuity (P=0.961), corneal graft clear rate (P=0.132) or the incidence of recurred fungal infection (P=0.770) between two groups. But there was a higher incidence of graft rejection (P=0.020) and secondary glaucoma (P=0.039) in group with corneal graft diameter 8.00mm or larger. CONCLUSION PKP is an effective treatment approach for fungal keratitis. There is a higher incidence of complications in large-diameter PKP for fungal keratitis. Effective, preventive and therapeutic measures can improve the prognosis.

[1]  Yang Jing,et al.  Spectrum of fungal keratitis in central China , 2009, Clinical & experimental ophthalmology.

[2]  A. Brahma,et al.  Penetrating keratoplasty: indications, outcomes, and complications , 2009, Eye.

[3]  M. Dana,et al.  Graft failure IV. Immunologic mechanisms of corneal transplant rejection , 2008, International Ophthalmology.

[4]  H. Beele,et al.  Graft failure: I. Endothelial cell loss , 2008, International Ophthalmology.

[5]  J. Zhao,et al.  [Retrospective study of suppurative keratitis in 1054 patients]. , 2007, [Zhonghua yan ke za zhi] Chinese journal of ophthalmology.

[6]  Weiyun Shi,et al.  Spectrum of fungal keratitis in north China. , 2006, Ophthalmology.

[7]  Lixin Xie,et al.  [Penetrating keratoplasty for treatment of fungal keratitis with corneal perforation]. , 2005, [Zhonghua yan ke za zhi] Chinese journal of ophthalmology.

[8]  W. Shi,et al.  [Clinical study on the endothelial immune rejection after penetrating keratoplasty]. , 2005, [Zhonghua yan ke za zhi] Chinese journal of ophthalmology.

[9]  E. S. Arcieri,et al.  A Study of Glaucoma After Penetrating Keratoplasty , 2002, Cornea.

[10]  R. Abbott,et al.  Corneal Graft Rejection: Recent Updates , 2002, International ophthalmology clinics.

[11]  J. Streilein,et al.  Role of recipient epithelium in promoting survival of orthotopic corneal allografts in mice. , 2001, Investigative ophthalmology & visual science.

[12]  R. Ayyala,et al.  Penetrating keratoplasty and glaucoma. , 2000, Survey of ophthalmology.