Outcome of therapeutic penetrating keratoplasty in a tertiary eye care center in Nepal

Leena Bajracharya, Reeta Gurung Department of Cornea, Tilganga Institute of Ophthalmology, Kathmandu, Nepal Background: Corneal ulcer is an important cause of blindness in developing countries. Therapeutic keratoplasty for infective keratitis is a frequently performed surgery in these countries.Ob...

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Autores principales:	Bajracharya L, Gurung R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Therapeutic penetrating keratoplasty infective keratitis Nepal Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/9fecd8242b934a54b79e75a22a0511b7
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spelling	oai:doaj.org-article:9fecd8242b934a54b79e75a22a0511b72021-12-02T02:44:51ZOutcome of therapeutic penetrating keratoplasty in a tertiary eye care center in Nepal1177-5483https://doaj.org/article/9fecd8242b934a54b79e75a22a0511b72015-12-01T00:00:00Zhttps://www.dovepress.com/outcome-of-therapeutic-penetrating-keratoplasty-in-a-tertiary-eye-care-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Leena Bajracharya, Reeta Gurung Department of Cornea, Tilganga Institute of Ophthalmology, Kathmandu, Nepal Background: Corneal ulcer is an important cause of blindness in developing countries. Therapeutic keratoplasty for infective keratitis is a frequently performed surgery in these countries.Objective: To find out the outcome of therapeutic keratoplasty for infective keratitis.Methods: Records of 5 years were reviewed of patients who underwent therapeutic keratoplasty from 2006 to 2010. Data collected included demographic parameters, indications for surgery, microbiology of the ulcers, type of surgery performed, and donor tissue details. In the follow-up period, ocular status was evaluated in terms of eradication of disease, anatomic success, graft clarity, visual acuity, and development of glaucoma and cataract.Results: In all, 180 eyes of 180 patients were enrolled in the study; 59.4% of the patients were male. Average age was 44.4±16.7 years. Overall, 71% of infective keratitis was perforated. A total of 101 (56%) eyes were positive for organisms of which 49 showed pure fungus and 49 showed pure bacteria. The commonest fungus and bacteria isolated were Aspergillus and Streptococcus, respectively. Average follow-up period was 29±23 months. Overall cure rate of infection was 88.8%, anatomical success rate was 89.5%, and graft clarity was 37.2%. Overall, 43.4% had secondary glaucoma. In the postoperative course, 65.8% of phakic eyes had developed cataract. In all, 38.6% of graft had endothelial failure and 24% of the graft failed due to late infective keratitis. Overall functional success with a visual acuity above 6/60 was 25.4%. Bacterial keratitis had a significantly higher cure rate, anatomical success, and graft clarity compared to fungal keratitis.Conclusion: Therapeutic keratoplasty is an important procedure to save the eye and preserve vision in severe infective keratitis. There is a high incidence of postoperative glaucoma, cataract, and graft failure in such a surgery. Bacterial keratitis has a better outcome than fungal keratitis. Keywords: therapeutic penetrating keratoplasty, infective keratitis, Nepal, corneal ulcer Bajracharya LGurung RDove Medical PressarticleTherapeutic penetrating keratoplastyinfective keratitisNepalOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss Issue 1, Pp 2299-2304 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Therapeutic penetrating keratoplasty infective keratitis Nepal Ophthalmology RE1-994
spellingShingle	Therapeutic penetrating keratoplasty infective keratitis Nepal Ophthalmology RE1-994 Bajracharya L Gurung R Outcome of therapeutic penetrating keratoplasty in a tertiary eye care center in Nepal
description	Leena Bajracharya, Reeta Gurung Department of Cornea, Tilganga Institute of Ophthalmology, Kathmandu, Nepal Background: Corneal ulcer is an important cause of blindness in developing countries. Therapeutic keratoplasty for infective keratitis is a frequently performed surgery in these countries.Objective: To find out the outcome of therapeutic keratoplasty for infective keratitis.Methods: Records of 5 years were reviewed of patients who underwent therapeutic keratoplasty from 2006 to 2010. Data collected included demographic parameters, indications for surgery, microbiology of the ulcers, type of surgery performed, and donor tissue details. In the follow-up period, ocular status was evaluated in terms of eradication of disease, anatomic success, graft clarity, visual acuity, and development of glaucoma and cataract.Results: In all, 180 eyes of 180 patients were enrolled in the study; 59.4% of the patients were male. Average age was 44.4±16.7 years. Overall, 71% of infective keratitis was perforated. A total of 101 (56%) eyes were positive for organisms of which 49 showed pure fungus and 49 showed pure bacteria. The commonest fungus and bacteria isolated were Aspergillus and Streptococcus, respectively. Average follow-up period was 29±23 months. Overall cure rate of infection was 88.8%, anatomical success rate was 89.5%, and graft clarity was 37.2%. Overall, 43.4% had secondary glaucoma. In the postoperative course, 65.8% of phakic eyes had developed cataract. In all, 38.6% of graft had endothelial failure and 24% of the graft failed due to late infective keratitis. Overall functional success with a visual acuity above 6/60 was 25.4%. Bacterial keratitis had a significantly higher cure rate, anatomical success, and graft clarity compared to fungal keratitis.Conclusion: Therapeutic keratoplasty is an important procedure to save the eye and preserve vision in severe infective keratitis. There is a high incidence of postoperative glaucoma, cataract, and graft failure in such a surgery. Bacterial keratitis has a better outcome than fungal keratitis. Keywords: therapeutic penetrating keratoplasty, infective keratitis, Nepal, corneal ulcer
format	article
author	Bajracharya L Gurung R
author_facet	Bajracharya L Gurung R
author_sort	Bajracharya L
title	Outcome of therapeutic penetrating keratoplasty in a tertiary eye care center in Nepal
title_short	Outcome of therapeutic penetrating keratoplasty in a tertiary eye care center in Nepal
title_full	Outcome of therapeutic penetrating keratoplasty in a tertiary eye care center in Nepal
title_fullStr	Outcome of therapeutic penetrating keratoplasty in a tertiary eye care center in Nepal
title_full_unstemmed	Outcome of therapeutic penetrating keratoplasty in a tertiary eye care center in Nepal
title_sort	outcome of therapeutic penetrating keratoplasty in a tertiary eye care center in nepal
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/9fecd8242b934a54b79e75a22a0511b7
work_keys_str_mv	AT bajracharyal outcomeoftherapeuticpenetratingkeratoplastyinatertiaryeyecarecenterinnepal AT gurungr outcomeoftherapeuticpenetratingkeratoplastyinatertiaryeyecarecenterinnepal
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Outcome of therapeutic penetrating keratoplasty in a tertiary eye care center in Nepal

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