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首页> 外文期刊>Indian Journal of Ophthalmology >Outcomes of therapeutic penetrating keratoplasty in 198 eyes with fungal keratitis
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Outcomes of therapeutic penetrating keratoplasty in 198 eyes with fungal keratitis

机译：198眼真菌性角膜炎治疗性穿透性角膜移植的结果

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Purpose: To study the outcomes of therapeutic penetrating keratoplasty in fungal keratitis. Methods: This retrospective, observational, interventional case series involved an audit of 198 consecutive eyes that underwent therapeutic penetrating keratoplasty (ThPK) for fungal keratitis at L V Prasad Eye Institute between January 2008 and December 2010 was performed. The data on demographics, clinical characteristics, intraoperative, and late postoperative complications were noted. The primary outcome measure was eradication of infection and postoperative anatomical success. Secondary outcome measures were graft survival, risk factors, clinical features, and management of recurrent fungal keratitis post ThPK. Results: Mean follow-up after ThPK was 24 ± 17 months. A total of 178 (89.9%) eyes had complete eradication of fungal infection, whereas 20 (10.1%) eyes developed recurrence. Anatomical restoration was achieved in majority of cases (192 eyes; 97%). Larger infiltrate size was associated with a higher risk of recurrence of infection. The median graft survival rate was 5.9 months. The graft survival was better for grafts 8 mm versus those with 8 mm (P = 0.026) and not found significantly related to the species of fungus. Twenty-seven eyes underwent re-grafting: penetrating keratoplasty in 14 eyes, and Descemet's stripping endothelial keratoplasty in 13 eyes. Conclusion: As larger infiltrate prior to therapeutic keratoplasty had much higher risk of recurrences; timely surgical intervention should be considered in cases not responding to medical therapy. Alternative strategies of management of postoperative inflammation need to be considered to prevent graft failures.
机译：目的：研究治疗性穿透性角膜移植术治疗真菌性角膜炎的效果。方法：该回顾性，观察性，干预性病例系列研究于2008年1月至2010年12月在L V Prasad眼科研究所对198眼接受了真菌性角膜炎治疗性穿透性角膜移植术（ThPK）的患者进行了审核。记录有关人口统计学，临床特征，术中和术后晚期并发症的数据。主要结果指标是根除感染和术后解剖学成功。次要结果指标是ThPK后移植物存活，危险因素，临床特征和复发性真菌性角膜炎的处理。结果：ThPK术后平均随访24±17个月。共有178只（89.9％）眼已完全根除真菌感染，而20只（10.1％）眼已复发。大多数病例（192眼; 97％）实现了解剖修复。较大的浸润大小与更高的感染复发风险相关。移植物中位生存期为5.9个月。 <8 mm的移植物比> 8 mm的移植物具有更好的存活率（P = 0.026），并且与真菌种类没有显着相关性。 27眼进行了再植：穿透性角膜移植术14眼，Descemet的剥离内皮角膜移植术13眼。结论：由于在治疗性角膜移植术之前较大的浸润发生率更高。如果对药物治疗无反应，应考虑及时的手术干预。为了防止移植失败，需要考虑采用替代的术后炎症处理策略。

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