[Treatment of fungal keratitis by penetrating keratoplasty].
BACKGROUND
Fungal keratitis is basically treated by medications. Several cases of fungal keratitis were reported around the world to have been treated successfully by corneal graft--penetrating keratoplasty (PKP). Studies have shown that PKP is a useful treatment, preserves eye globe integrity, and rehabilitates vision in patients with advanced fungal keratitis.


OBJECTIVE
To study the use of penetrating keratoplasty for the treatment of severe fungal keratitis that could not be cured by antifungal medication.


METHODS
The authors conducted a retrospective analysis of all cases (five cases) of severe fungal keratitis treated and followed-up at the Department of Ophthalmology, Soroka University Medical Center during 2007 and 2008, in which therapeutic PKP was performed. There were one male and 4 females. The age range was between 27 and 78 years. The follow-up period ranged from 4 to 15 months.


RESULTS
Corneal graft remained clear during follow-up in most patients. There was no recurrence of fungal infection and the visual acuity ranged from counting fingers (FC) from 50 cm to 6/36. Complications in some patients included graft rejection in one patient with re-graft which remained clear during follow-up period of 6 months, another patient had a minimal partial graft rejection and incipient cataract which didn't necessitate further intervention.


CONCLUSIONS
PKP is an effective treatment for fungal keratitis that does not respond to antifungal medication. Early surgical intervention before deterioration is recommended.
Imtirat
A'hed
A
Department of Ophthatmology, Soroka University Medical Center Ben-Gurion University of the Negev. amtirat@gmail.com
Levy
Jaime
J
Lifshitz
Tova
T
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000601:surgery; D002177:Candidiasis / Q000188:drug therapy / Q000601:surgery; D015821:Eye Infections, Fungal / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D005670:Fusarium / Q000302:isolation & purification; D006801:Humans; D007634:Keratitis / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male
D000935:Antifungal Agents