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Session Title: Cornea Surgical II
Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30
Paper Time: 09:34
Venue: Forum (Ground Floor)
First Author: : J.Rosandic SPAIN
Co Author(s): : M. de la Paz C. Ponce de los Rios J. Alvarez de Toledo
Purpose: to describe the anatomical and functional outcomes of patients who underwent penetrating keratoplasty for acanthamoeba keratitis.
Centro de Oftalmologia Barraquer/Barcelona/Spain Barraquer Ophthalmology Center
Methods: This is a retrospective study on 16 eyes of 16 patients who underwent penetrating keratoplasty for acanthamoeba keratitis at our eye center from 1995 -2009. Data on preoperative factors like use of contact lenses, visual acuity and treatment, as well as post-operative data like graft diameter, intraocular pressure, complications and treatment were evaluated. Graft survival was evaluated with the Kaplan-Meier life table analysis and comparisons were performed using Log-rank.
Results: 68% of the patients were women, and mean age was 35.5 (+/- 12.6) years. 68% reported use of contact lens prior to infection. 6.8% reported ocular trauma as a possible cause of the keratitis. In the post-operative follow-up, 56% developed glaucoma, 75% developed cataract, 12.5% had retinal detachment and 6.2% ended up in endophthalmitis. 9 patients required a second penetrating keratoplasty due to graft failure. 43% maintained a clear graft during the first year post-operation. 2 patients had recurrence of acanthamoeba keratitis onto the graft.
Conclusion: Penetrating keratoplasty is a viable treatment option in patients with acanthamoeba keratitis who do not respond to medical treatment. However, graft survival has guarded prognosis due to the aggressiveness of the infection, as well as the medical treatment which has to be continued in the post-operative period. Post-operative glaucoma and cataract are post-operative complications which may condition the anatomical and functional success of the graft.
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