[Clinical application of irrigation in therapeutic keratoplasty for suppurative keratitis with severe hypopyon].

Abstract

OBJECTIVE:

To investigate the safety and clinical efficacy of anterior chamber irrigation combined with corneal transplantation in the treatment of corneal ulcer with severe hypopyon.

METHODS:

Non-randomized retrospective case series. Twenty patients (20 eyes) suffered from corneal ulcer with severe hypopyon were enrolled in Shandong Eye Hospital from January 2008 to June 2009, and 13 patients with significant corneal endothelial plaque, which hard to determine the lesion edge under microscope. Twenty patients received anterior chamber irrigation combined with penetrating or lamellar keratoplasty treatment; the donors were preserved in the medium-term preservation solution or freeze-dry preservation of glycerine. Intraoperative and postoperative complications, visual acuity, immune rejection were collected as outcome measures.

RESULTS:

Twenty cases received anterior chamber irrigation combined with corneal transplantation successfully, eleven of which received penetrating keratoplasty (PK) and 9 received lamellar keratoplasty (LK). Ten cases that underwent PK using donors preserved in medium-term solution, and the remaining using donors cryopreserved at -20 degrees C. Intraoperative complications include bleeding iris (11 cases), postoperative complications including iris adhesions (8 cases), transient high intraocular pressure (4 cases), anterior chamber hemorrhage (5 cases), and were cured after drug treatment. One case suffered recurrence of fungal keratitis and received repeat PK. Four cases occurred endothelial immune rejection, 3 cases were controlled and 1 case occurred graft failure after anti-rejection treatment. In the final follow-up in December 2009, 17 grafts were clear and 3 grafts were edema.

CONCLUSION:

In the treatment of severe corneal ulcer with hypopyon, anterior chamber irrigation combined with penetrating or lamellar keratoplasty is an effective and a safety method.

• Authors: Hua Gao, Ting Wang, Ju Zhang, Su-xia Li, Wei-yun Shi
• Journal: [Zhonghua yan ke za zhi] Chinese journal of ophthalmology (Zhonghua Yan Ke Za Zhi) Vol. 46 Issue 5 Pg. 400-4 (May 2010) ISSN: 0412-4081 [Print] China
• PMID: 20654211 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Anterior Chamber
• Corneal Transplantation (methods)
• Corneal Ulcer (surgery)
• Empyema
• Female
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Therapeutic Irrigation
• Treatment Outcome
• Young Adult