Study identifies factors associated with lamellar keratoplasty failure in fungal

[Guest guest]

Study identifies factors associated with lamellar keratoplasty

failure in fungal keratitis cases

OSN SuperSite - Thorofare,NJ*

http://www.osnsupersite.com/view.asp?rID=25662

Patients treated with lamellar keratoplasty for fungal keratitis may

have a significantly higher risk of failure if Aspergillus species

caused the infection, if they show the presence of hypopyon or

endothelial plaque before surgery, or if they receive

glucocorticoids or immunosuppressants postoperatively, according to

a study by researchers in China.

" Prompt recognition and management of failed [lamellar keratoplasty]

with [penetrating keratoplasty] can achieve successful outcomes, "

the authors said.

Lixin Xie, MD, and colleagues at Shandong Eye Institute in Qingdao

investigated risk factors for failure of lamellar keratoplasty in

218 eyes of 218 patients. All cases had fungal keratitis that had

failed to respond to medical therapy.

All eyes received antifungal drugs for at least 7 days before

surgery.

Surgeons used a trephine with a diameter that was 0.5 mm larger than

the fungal infection to create the lamellar keratoplasty incisions

and excise the ulcers, according to the study.

Overall, 17 patients (7.8%) experienced treatment failure within 2

weeks after lamellar keratoplasty, including 15 patients who failed

within 1 week postop.

Any cases of treatment failure subsequently underwent PK, the

authors noted.

" All cases of treatment failure displayed increasing local

irritation and hyphal infiltration in the recipient [lamellar

keratoplasty] bed and subsequently were cured by PK, " they said.

" A higher rate of inadequate treatment with [lamellar keratoplasty]

was found in the cases with Aspergillus species, in those to whom

glucocorticoids or immunosuppressants were administered, and in

those with hypopyon or endothelial plaque before [lamellar

keratoplasty], " the authors noted.

The study is published in the January issue of Ophthalmology.

[Guest guest]

Logical! I would expect this. Sounds like a decent piece of published

peer-reviewed literature! Nice find. Thank you for sharing.

Nina