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I. A. Chaudhry, W. Al-Rashed, F. A. Shamsi, Y. O. Arat, E. Elzaridi, M. Bouhaimad; Prevalence of Microbial Keratitis in Patients With Trachoma in the Setting of Canaliculitis or Dacryocystitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2415.
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To report incidence of microbial keratitis in patients with trachoma and having canaliculitis or dacryocystitis presenting to a tertiary eye care center in the Middle East .
A retrospective clinical study of microbial keratitis in patients with trachoma in the setting of canaliculitis and dacryocystitis (acute or chronic), treated in the Oculoplastic Division of King Khaled Eye Specialist Hospital, Riyadh, Saudi Arbiab, a tertiary eye care referral center was conducted over a 2 year period.
There were 182 patients (118 females, 64 males) with average age of 63.3 years (range, 11 to 95 years).All of these patients had clinical evidence of old trachomatous scarring, while 3 children and 3 adults had evidence of active trachoma. Dacryocystitis (acute or chronic) was found in 38 (20.9%) patients and canaliculitis (acute or chronic) in 26 (14.3%) patients. Forty-six (25.3%) patients required dacryocystorhinostomies (DCRs) and 16 patients required exploration of their canalicular systems. From the 28 patients in whom cultures were obtained prior to or during thier DCRs, 26 patients had microbial growths. From the 16 patients with canaliculitis who required exploration, 14 had microbial growth from the cultures obtained. Microbial keratitis was found in 25 patients who were also found to have unrecognized canaliculitis or dacryocystitis. Thirty-five (19.2%) patients required penetrating keratoplasty, 18 had failed grafts, repeat grafting was performed in 9 eyes. Patients having patent nasolacriaml drainage system were less likely to have evidence of microbial keratitis (p<0.01). Gram positive microorganisms were more likely to be the cause of dacryocystitis, canaliculitis as well as microbial keratitis.
Risk of microbial keratitis may be increased in patients having trachomatous scarring and canaliculitis or dacryocystitis. These findings urge early recognition and treatment of dacryocystitis or canaliculitis to prevent severe visual loss due to microbial keratitis.
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