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J. Hade, B. D. Ayres, D. S. Chu; Surgical Outcomes in Cases of Fusarium Keratitis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4694.
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This study aims to review cases of Fusarium keratitis associated with contact lens use which have resulted in corneal transplants and to analyze the clinical outcome of these patients.
Following a retrospective review of medical records involving cases of culture confirmed Fusarium keratitis that were seen at the Institute of Ophthalmology and Visual Science at New Jersey Medical School and Wills Eye Hospital, a series of 7 patients (7 eyes) ages 39 to 62 were identified. Numerous data were extracted from each record including age, date of onset of symptoms, date of corneal transplant, duration of medical therapy prior to corneal transplant, duration of antifungal therapy prior to corneal transplant, duration from time of symptom onset to start of antifungal therapy, agents of medical therapy, location and size of ulcer, presence and size of hypopyon, visual acuity at time of presentation, visual acuity immediately prior to corneal transplant, visual acuity post operative day 1, week 1, month 1, month 3 and month 6, and any operative or medical complications.
All identified patients underwent corneal transplantation. All affected eyes had ulcer involvement of the central visual axis. Pre-op visual acuities were all either hand motion or count fingers. Initial post-operative visual acuities on day 1 ranged from hand motion to 20/100 by pinhole. Visual acuities at 3 months post-op ranged from 20/50 pinhole to hand motion. Three of the seven patients experienced graft failure within -- months. These patients had been noted to have had larger sized hypopyons and ulcers prior to transplantation.
Size of hypopyon and size of ulcer may be associated with the rate of graft success and visual improvement after corneal transplantation in cases of Fusarium keratitis associated with contact lens use.
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