Cornea - I Free Papers - aioseducation

Cornea Free Papers
• It may provide an additional strategy in improving success of corneal
grafts in these patients.
• This is a short term study. However long-term follow-up is necessary to
determine whether repeat injections are necessary.
Risk Factors in Management of Bacterial Keratitis
Dr. Samrat Chatterjee, Dr. Deepshikha Agrawal
Infectious keratitis continues to be a major cause of corneal blindness in
developing countries. Timely presentation, specific diagnosis and treatment
with appropriate antimicrobial agents can limit ocular morbidity. The
knowledge of risk factors affecting treatment outcome helps in modifying
management protocols and also in prognostication. 1-5 A previous study
from our Institute examined the risk factors affecting outcome after medical
management of fungal keratitis [Risk factors for poor outcome in medical
management of fungal keratitis. Chatterjee S, et al. Paper presented at Annual
Conference of All India Ophthalmological Conference, Kolkata, 2010]. In this
present study, risk factors affecting outcome after medical management of
bacterial keratitis are being examined.
MATERIALS AND METHODS
This was a retrospective, interventional case series which included all
microbiologically proven cases of bacterial keratitis diagnosed at the Cornea
Services in MGM Eye Institute, Raipur (2005-2009). Medical records were
examined and factors like age, gender, distance from institute, presentation time,
treatment history prior to presentation, steroid use, initial visual acuity, ulcer
size and depth, corneal thinning/perforation, presence of endophthalmitis,
etc were correlated to poor outcome. Poor outcome to medical therapy was
considered when the ulcer failed to heal with medications or progressed to
perforation or required penetrating keratoplasty or underwent evisceration.
Each patient who presented with corneal ulcer at our Institute underwent
corneal scraping and microbiological investigations that included culture in
appropriate media and antibiotic susceptibility by Kirby Bauer disc method.
Medical treatment was with either combined fortified cefazolin eye drops
(50mg/ml) and tobramycin (14mg/ml) or monotherapy with fluoroquinolones.
The initial drug chosen was modified according to antibiotic susceptibility
reports and clinical response. Patients not responding to medical therapy were
considered for therapeutic penetrating keratoplasty. In patients where corneal
integrity was threatened with corneal thinning, descemtocele formation or
perforation, tissue adhesive was applied. Univariate analysis was done with
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