ESCRS - PO696 - Frequency And Outcome Of Emergency Penetrating Keratoplasty In Infectious Keratitis In Sweden During The 21St Century

Frequency And Outcome Of Emergency Penetrating Keratoplasty In Infectious Keratitis In Sweden During The 21St Century

Published 2024 - 42nd Congress of the ESCRS

Reference: PO696 | Type: Poster | DOI: 10.82333/phwa-h415

Authors: Andreas Viberg* 1 , Berit Byström 1

1Dept of Clinical Sciences, Ophthalmology,Umeå University,Umeå,Sweden

Purpose

To study the frequency over time, and outcome of corneal transplantation, “keratoplasty à chaud” in patients with infectious keratitis with two-year follow-up data.

Setting

Swedish cornea transplantation units.

Methods

Register-based study including keratitis cases that had undergone a corneal transplantation in Sweden between 2001 and 2020 and were reported to the Swedish Corneal Transplant Register.

Results

During the study period, 69 eyes were subjected to acute penetrating keratoplasty (PK) due to progressive infectious keratitis. The number increased from two annual procedures in the first half of the studied period to five in the second half (P=.01). A preoperative corneal perforation was present in 43.5% (n=30). Two years after surgery, follow-up data was completed for 53 eyes, of these 62.3% (n=33) were considered having functioning grafts, and 20.8% (n=11) had experienced a rejection episode. The median visual acuity improved from hand motion to counting fingers (P=.002) and the proportion of eyes with a visual acuity of 20/200 or better increased from 5.7% (n=3) before the surgery to 45.3% (n=24) at the two-year follow-up (P<.001).

Conclusions

The number of active infectious keratitis undergoing a keratoplasty à chaud increased in Sweden during the 21st century. The majority of the cases were successful regarding the structural integrity of the bulb, that is “had a saved eye” and even a functioning graft two years after corneal transplantation. The visual gain was distinct, albeit modest. In cases with severe infectious keratitis, and even a concomitant perforation in the cornea due to the infection, corneal transplantation should continue to be an option.