Abstract：
OBJECTIVE: To assess outcomes of keratoplasty performed in patients diagnosed with keratitis caused by Pythium insidiosum (PI).
METHODS: Retrospective review.
METHODS: Preoperative, intra operative and post operative data of patients diagnosed with PI keratitis and who underwent keratoplasty for their condition from January 2020 to December 2021 were collected from the central patient database of a tertiary eye care hospital in India. The data were analyzed for anatomic success, elimination of infection, graft survival, incidence of repeat keratoplasty, final visual acuity and varied complications.
RESULTS: In total, 16 eyes underwent penetrating keratoplasty for PI keratitis during the study period. Mean time to keratoplasty from onset of symptoms was 31.3 days and mean graft size was 10.4 mm. Nine out of the 16 cases had recurrence of infection following surgery, seven of which required a repeat keratoplasty for elimination of infection. Mean graft size for repeat keratoplasty performed in recurrent cases was 11.7 mm. Globe was successfully salvaged in 14 out of 16 patients (87.5 %). Three grafts remained clear at 6-month follow up while 11 grafts failed. Mean improvement in uncorrected visual acuity from 2.32 to 2.04 logMAR was observed at last follow up. Endo-exudates, graft infiltration, graft dehiscence, secondary glaucoma and retinal detachment were the various complications noted after keratoplasty.
CONCLUSIONS: PI keratitis is a tenacious and potentially blinding condition. Keratoplasty remains the choice of treatment in this condition, however recurrence of disease and graft failure are common. Large sized grafts, meticulous per-operative removal of infection, adjuvant cryotherapy, and intraoperative and post operative use of antibiotics can help in improving outcome of keratoplasty in these patients.
METHODS: Retrospective review.
METHODS: Preoperative, intra operative and post operative data of patients diagnosed with PI keratitis and who underwent keratoplasty for their condition from January 2020 to December 2021 were collected from the central patient database of a tertiary eye care hospital in India. The data were analyzed for anatomic success, elimination of infection, graft survival, incidence of repeat keratoplasty, final visual acuity and varied complications.
RESULTS: In total, 16 eyes underwent penetrating keratoplasty for PI keratitis during the study period. Mean time to keratoplasty from onset of symptoms was 31.3 days and mean graft size was 10.4 mm. Nine out of the 16 cases had recurrence of infection following surgery, seven of which required a repeat keratoplasty for elimination of infection. Mean graft size for repeat keratoplasty performed in recurrent cases was 11.7 mm. Globe was successfully salvaged in 14 out of 16 patients (87.5 %). Three grafts remained clear at 6-month follow up while 11 grafts failed. Mean improvement in uncorrected visual acuity from 2.32 to 2.04 logMAR was observed at last follow up. Endo-exudates, graft infiltration, graft dehiscence, secondary glaucoma and retinal detachment were the various complications noted after keratoplasty.
CONCLUSIONS: PI keratitis is a tenacious and potentially blinding condition. Keratoplasty remains the choice of treatment in this condition, however recurrence of disease and graft failure are common. Large sized grafts, meticulous per-operative removal of infection, adjuvant cryotherapy, and intraoperative and post operative use of antibiotics can help in improving outcome of keratoplasty in these patients.
摘要：
目的：评估被诊断为由阴沟腐霉（PI）引起的角膜炎的患者进行角膜移植术的结果。
方法：回顾性回顾。
方法：术前，我们从印度一家三级眼科护理医院的中心患者数据库中收集了2020年1月至2021年12月诊断为PI角膜炎并因其病情接受角膜移植术的患者的术中和术后数据.对数据进行了解剖成功分析，消除感染，移植物存活，重复角膜移植术的发生率，最终视力和各种并发症。
结果：总计，在研究期间，有16只眼接受了穿透性角膜移植术治疗PI角膜炎。从症状开始进行角膜移植术的平均时间为31.3天，平均移植物大小为10.4mm。16例中有9例手术后感染复发,其中7例需要重复角膜移植术以消除感染。在复发病例中进行的重复角膜移植术的平均移植物大小为11.7mm。16例患者中有14例成功挽救了Globe（87.5％）。在6个月的随访中，有3例移植物仍然清晰，而11例移植物失败。在最后一次随访中观察到未矫正视力从2.32到2.04logMAR的平均改善。内分泌，移植物浸润，移植物开裂，继发性青光眼和视网膜脱离是角膜移植术后的各种并发症。
结论：PI角膜炎是一种顽固性和潜在致盲的疾病。在这种情况下，角膜移植术仍然是治疗的选择，然而，疾病复发和移植物衰竭是常见的。大型移植物，每次手术都一丝不苟地去除感染，辅助冷冻疗法，术中和术后使用抗生素可以帮助改善这些患者的角膜移植术的结果。
方法：回顾性回顾。
方法：术前，我们从印度一家三级眼科护理医院的中心患者数据库中收集了2020年1月至2021年12月诊断为PI角膜炎并因其病情接受角膜移植术的患者的术中和术后数据.对数据进行了解剖成功分析，消除感染，移植物存活，重复角膜移植术的发生率，最终视力和各种并发症。
结果：总计，在研究期间，有16只眼接受了穿透性角膜移植术治疗PI角膜炎。从症状开始进行角膜移植术的平均时间为31.3天，平均移植物大小为10.4mm。16例中有9例手术后感染复发,其中7例需要重复角膜移植术以消除感染。在复发病例中进行的重复角膜移植术的平均移植物大小为11.7mm。16例患者中有14例成功挽救了Globe（87.5％）。在6个月的随访中，有3例移植物仍然清晰，而11例移植物失败。在最后一次随访中观察到未矫正视力从2.32到2.04logMAR的平均改善。内分泌，移植物浸润，移植物开裂，继发性青光眼和视网膜脱离是角膜移植术后的各种并发症。
结论：PI角膜炎是一种顽固性和潜在致盲的疾病。在这种情况下，角膜移植术仍然是治疗的选择，然而，疾病复发和移植物衰竭是常见的。大型移植物，每次手术都一丝不苟地去除感染，辅助冷冻疗法，术中和术后使用抗生素可以帮助改善这些患者的角膜移植术的结果。
