Corneal graft survival after therapeutic keratoplasty for Acanthamoeba keratitis

Corneal graft survival after therapeutic keratoplasty for Acanthamoeba keratitis

Author Kashiwabuchi, Renata T. Autor UNIFESP Google Scholar
Freitas, Denise de Autor UNIFESP Google Scholar
Alvarenga, Lenio S. Autor UNIFESP Google Scholar
Vieira, Luiz Autor UNIFESP Google Scholar
Contarini, Patricia Autor UNIFESP Google Scholar
Sato, Elcio Autor UNIFESP Google Scholar
Foronda, Annette Google Scholar
Hofling-Lima, Ana Luisa Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Abstract Purpose: To describe corneal graft survival and visual outcome after therapeutic penetrating keratoplasty in patients with Acanthamoeba keratitis (AK) that is unresponsive to clinical treatment.Methods: Retrospective study. Thirty-two patients with AK who underwent therapeutic penetrating keratoplasty (tPK) from August 1996 to August 2005 were included. Data relating to clinical features, visual acuity, surgical technique, graft survival and complications were collected. Graft survival was evaluated by the Kaplan-Meier method and comparisons were performed using the Log-rank test.Results: Most patients (62.5%) were female. Mean age [+/- standard deviation (SD)] was 35 (+/- 13) years (range 15-68 years). All patients were contact lens wearers. Eighteen patients (56%) presented paralytic mydriasis and glaucoma during the treatment. Thirteen patients (40%) developed glaucoma after surgery; eight of them (61%) required a second PK because of graft failure. of the 32 keratoplasty eyes, 56.2% presented graft failure at any follow-up point. Forty-five per cent of graft failures occurred before the 12 month follow-up, so 55% remained clear in the first year after surgery. Twelve patients underwent a second PK; seven of them failed and 45% were clear at 1 year. Two patients presented graft recurrence of amoebic infection. There was no significant difference in graft survival when eyes with or without mydriasis were compared (P = 0.40). Eyes with glaucoma presented a significantly shorter graft survival (P = 0.01).Conclusion: Penetrating keratoplasty is a treatment option for eyes that are unresponsive to clinical treatment infections. However, graft survival is poor; postoperative glaucoma is frequent and is associated with shorter graft survival.
Keywords Acanthamoeba keratitis
graft survival
survival curve
Language English
Date 2008-09-01
Published in Acta Ophthalmologica. Malden: Wiley-Blackwell, v. 86, n. 6, p. 666-669, 2008.
ISSN 1755-375X (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 666-669
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000258726900015

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