June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Outcomes and timing of surgical intervention in eyes with microbial keratitis treated with therapeutic penetrating keratoplasty
Author Affiliations & Notes
  • Troy Teeples
    University of Colorado, Denver, Colorado, United States
  • Karen L. Christopher
    University of Colorado, Denver, Colorado, United States
  • Scott G Hauswirth
    University of Colorado, Denver, Colorado, United States
  • Jennifer L. Patnaik
    University of Colorado, Denver, Colorado, United States
  • Footnotes
    Commercial Relationships   Troy Teeples None; Karen Christopher None; Scott Hauswirth None; Jennifer Patnaik None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4345 – A0282. doi:
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      Troy Teeples, Karen L. Christopher, Scott G Hauswirth, Jennifer L. Patnaik; Outcomes and timing of surgical intervention in eyes with microbial keratitis treated with therapeutic penetrating keratoplasty. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4345 – A0282.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine the rates of persistent infection, secondary glaucoma and visual acuity outcomes for patients who underwent penetrating keratoplasty (PKP) for an infectious corneal ulcer, as well as determine how timing of therapeutic PKP affects surgical outcomes.

Methods : A retrospective review was conducted of patients who underwent PKP between the years 2014 and 2020 at an academic medical center in Aurora, Colorado. Demographic information, insurance coverage, pre-operative exam findings, infectious organism, and size of transplant were compared for the outcomes of recurrent infection, transplant failure or rejection, secondary glaucoma and visual acuity before and after transplant. Chi-square testing was used for categorical comparisons and the Wilcoxon rank sum test for continuous variables.

Results : 56 patients (56 eyes) underwent PKP for an infectious corneal ulcer during the study period. There were 27 females (48.2%) and 29 males (51.2%) with a mean age of 58.3 (standard deviation 18). The most common infectious organism was bacterial (55.4%) followed by fungal (10.7%), viral (7.1%) and acanthamoeba (7.1%). For patients that had at least 30 days of clinic follow up after PKP (n = 46), 17 (37.0%) had recurrent infection, 16 (34.8%) had transplant failure or rejection, 16 (34.8%) developed secondary glaucoma, 15 (32.6%) required repeat PKP and 16 (35.6%) had post-op vision better than 20/200. Neither the infectious organism nor the size of the ulcer or donor transplant had any impact on post-operative outcomes. Those who developed recurrent infection following PKP had a greater duration of time between ulcer onset and PKP than those who did not (median 60 days from ulcer onset to PKP vs 17.5 days, p= 0.02). Those who developed secondary glaucoma had a greater duration of time between ulcer onset to date of PKP compared to those who did not develop secondary glaucoma (median 60 vs 14 days, p= 0.04).

Conclusions : Neither the infectious organism (bacterial, viral, fungal, acanthamoeba) nor the size of the ulcer or donor transplant had any impact on post-operative outcomes (recurrent infection, transplant failure, secondary glaucoma, visual acuity) following PKP. On average, patients who had recurrent infection and patients who developed secondary glaucoma underwent PKP later following ulcer onset compared to those who did not.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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