Abstract
Purpose: :
To determine if neutrophyl quantification in blood is a prognostic factor in patients with perforated infectious keratitis treated with tectonic graft.
Methods: :
A retrospective , longitudinal, observational and comparative study was made. Files of patients with diagnosis of perforated infectious keratitis of any etiology with preoperative cell blood count and treated with tectonic graft from 2002 to 2007 were reviewed. Relation between percentage of blood neutrophiles, success of tectonic graft and etiology of keratitis was done. Successful group was considered when the graft had no major complications in a two months period, under clinical characteristics such as clearness, dehiscence, neovascularization, lysis, and epithelial integrity. Failure group was considered when uncontrolled inflammatory process secondary to systemic disease, infectious etiology or immunologic response was seen. We stratified percentage of blood neutrophyls into two groups: Group A < 60% and the group B ≥ 60%.
Results: :
A total of 141 files were reviewed, 97 files were included. By etiology : Bacterial 47, viral 26, fungal 17 and 7 mixed cases Group A: 15 cases, all of them were considered successful. The etiologies in this group is as follows : Bacterial 53%, viral 26%, fungal 7%, mixed 13% Etiology in this group was as follows: Group B: 61 out of 82 cases failed. Etiology in this group was as follows: Bacterial 64%, 73.3% viral, 87.5% micotic and the 100% in the mixed one.(p=0.005)
Conclusions: :
There is a correlation between neutrophilia and failure tectonic graft. Neutrophylia is a negative prognostic factor for tectonic graft survival. No correlation between neutrophilia and etiology was found.
Keywords: clinical (human) or epidemiologic studies: risk factor assessment • cornea: clinical science • fungal disease