title: Minimal trephination penetrating keratoplasty for severe fungal keratitis complicated with hypopyon.
abstract: OBJECTIVE
  To report outcomes after minimal trephination penetrating keratoplasty (PKP) in the treatment of severe fungal keratitis complicated with hypopyon.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Series of 19 eyes in 19 patients with severe fungal keratitis complicated with hypopyon that received minimal trephination PKP.
  
  
  METHODS
  The host trephination was made equal to or smaller than the margin of the corneal lesion. Fluconazole (0.2%) was used to irrigate the trephined edge and anterior chamber during surgery, followed by irrigation of the anterior chamber with a 0.02% fluconazole solution after graft transplantation. Postoperative complications, graft rejection, transparency rate, and visual acuity were recorded.
  
  
  RESULTS
  Patients were followed postoperatively for 18 to 34 months (mean 28.6 months). At 18 months after PKP, 18 grafts (94.7%) remained clear and 14 eyes (73.7%) had improved visual acuity. Three eyes (15.8%) with secondary glaucoma complications after PKP were treated with subsequent trabeculectomy. Recurrent infection was found in only 1 eye (5.26%) after transplantation and was successfully managed. Immune graft rejections were not observed in any patient during the follow-up period.
  
  
  CONCLUSIONS
  The minimal trephination technique in combination with antifungal therapy was effective in the treatment of severe fungal keratitis with large corneal lesions and hypopyon.
authors: Department of Ophthalmology, First Hospital of Jilin University, Changchun, People's Republic of China; and.
authors: Yang
authors: Y
authors: Liu
authors: Hui
authors: H
authors: Jia
authors: Xiaoru
authors: X
authors: Shi
authors: Jiao
authors: J
authors: Wang
authors: Yan
authors: Y
authors: Ning
authors: Bing
authors: B
authors: He
authors: Chunmei
authors: C
authors: Wang
authors: Xiaodong
authors: X
authors: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D001230:Aspergillus / Q000302:isolation & purification; D002176:Candida albicans / Q000302:isolation & purification; D003131:Combined Modality Therapy; D003315:Cornea / Q000382:microbiology; D003320:Corneal Ulcer / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D004653:Empyema / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D005670:Fusarium / Q000302:isolation & purification; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole