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Tomoko Tsukahara, Yusuke Saeki, Jane Yuh-Huey Huang, Eiichi Uchio; Treatment outcomes of keratoplasty with atopic dermatitis.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1549.
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© ARVO (1962-2015); The Authors (2016-present)
Keratoplasty in patients with atopic dermatitis (AD) has a higher potential risk of, graft rejection, infection and rarely postkeratoplastic atopic sclerokeratitis (PKAS). Nevertheless, given early detection and a high degree of suspicion and immediate treatment could improve graft survival. We report our outcomes and treatments for atopic patients undergoing keratoplasty (KP).<br />
We investigated medical records of 183 KP patients from November, 2005 to March, 2014 retrospectively. Nine patients, 9 eyes had AD. We evaluated on the age, diagnosis before KP, perioperative treatments, and the success rate in these patients.
The average age was 44.1 years old. Among the nine eyes, 6 eyes were keratoconus, 2 eyes were bullous keratopathy, 1 eye was perforation of cornea and 1 eye was granular corneal dystrophy. Seven eyes underwent penetrating keratoplasty (PKP) and 2 eyes lamellar keratoplasty (LKP). Six patients were in an active state of AD at the time of keratoplasy. All patients were prescribed systemic immuosuppressants or corticosteroids during perioperative period. Postoperative complications included 4 eyes with cornea graft rejection, 2 eyes with methicillin-resistant staphylococcus aureus (MRSA) culture positive from the graft and anterior chamber. No PKAS case was observed in the study.
In our study, AD patients showed risk of MRSA infections and rejection. High degree of suspicion and early treatment with systemic immunosuppressants or corticosteroids could improve graft survival in high risk atopic patients.
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