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Post-corneal transplant Candida keratitis – Incidence and outcome

PURPOSE: To report the risk factors, clinical characteristics, and outcomes of Candida keratitis following corneal transplantation in India. METHODS: On retrospective review of medical records of 789 patients, 31 eyes developed a graft infection following corneal transplantation or keratoprosthesis...

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Autores principales: Sati, Alok, Wagh, Sangeeta, Mishra, Sanjay K, Kumar, Sonali V, Kumar, Pradeep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9023991/
https://www.ncbi.nlm.nih.gov/pubmed/35086233
http://dx.doi.org/10.4103/ijo.IJO_560_21
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author Sati, Alok
Wagh, Sangeeta
Mishra, Sanjay K
Kumar, Sonali V
Kumar, Pradeep
author_facet Sati, Alok
Wagh, Sangeeta
Mishra, Sanjay K
Kumar, Sonali V
Kumar, Pradeep
author_sort Sati, Alok
collection PubMed
description PURPOSE: To report the risk factors, clinical characteristics, and outcomes of Candida keratitis following corneal transplantation in India. METHODS: On retrospective review of medical records of 789 patients, 31 eyes developed a graft infection following corneal transplantation or keratoprosthesis and we could identify the Candida infection in only five. These cases were operated at two tertiary care centers in India. These five records were reviewed for demographics, risk factors (local and systemic) for graft infection, characteristics of infective lesion, corneal scraping results, treatment plan, and the final outcome following management. RESULTS: The median age of the subjects with the Candida graft infection was 62.4 ± 10.33 years (range, 62–71 years). All patients were males. The predominant risk factors included repeat corneal transplantation (5/5), prolonged usage of topical steroids (5/5), and epithelial defects (4/5). The clinical characteristics included infiltrates of variable configuration like powdery deposits, white plaque, fluffy white infiltrate, and crystalline keratopathy. The smear showed budding yeasts in all five cases whereas culture was positive in four out of five cases. The final outcome with antifungals (systemic [4/5] and topical [5/5]) is variable. Two eyes underwent evisceration, two eyes had scar formation in the failed grafts, and one patient succumbed to the systemic disease 1-month post-corneal infection. CONCLUSION: Candida keratitis, in India, seems to be an emerging pathology following corneal transplantation and has a varied presentation. Though the outcomes following management seem to be grim, however, such infection can easily be avoided by a timely reduction of the risk factors.
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spelling pubmed-90239912022-04-23 Post-corneal transplant Candida keratitis – Incidence and outcome Sati, Alok Wagh, Sangeeta Mishra, Sanjay K Kumar, Sonali V Kumar, Pradeep Indian J Ophthalmol Special Focus, Cornea, Original Article PURPOSE: To report the risk factors, clinical characteristics, and outcomes of Candida keratitis following corneal transplantation in India. METHODS: On retrospective review of medical records of 789 patients, 31 eyes developed a graft infection following corneal transplantation or keratoprosthesis and we could identify the Candida infection in only five. These cases were operated at two tertiary care centers in India. These five records were reviewed for demographics, risk factors (local and systemic) for graft infection, characteristics of infective lesion, corneal scraping results, treatment plan, and the final outcome following management. RESULTS: The median age of the subjects with the Candida graft infection was 62.4 ± 10.33 years (range, 62–71 years). All patients were males. The predominant risk factors included repeat corneal transplantation (5/5), prolonged usage of topical steroids (5/5), and epithelial defects (4/5). The clinical characteristics included infiltrates of variable configuration like powdery deposits, white plaque, fluffy white infiltrate, and crystalline keratopathy. The smear showed budding yeasts in all five cases whereas culture was positive in four out of five cases. The final outcome with antifungals (systemic [4/5] and topical [5/5]) is variable. Two eyes underwent evisceration, two eyes had scar formation in the failed grafts, and one patient succumbed to the systemic disease 1-month post-corneal infection. CONCLUSION: Candida keratitis, in India, seems to be an emerging pathology following corneal transplantation and has a varied presentation. Though the outcomes following management seem to be grim, however, such infection can easily be avoided by a timely reduction of the risk factors. Wolters Kluwer - Medknow 2022-02 2022-01-27 /pmc/articles/PMC9023991/ /pubmed/35086233 http://dx.doi.org/10.4103/ijo.IJO_560_21 Text en Copyright: © 2022 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Special Focus, Cornea, Original Article
Sati, Alok
Wagh, Sangeeta
Mishra, Sanjay K
Kumar, Sonali V
Kumar, Pradeep
Post-corneal transplant Candida keratitis – Incidence and outcome
title Post-corneal transplant Candida keratitis – Incidence and outcome
title_full Post-corneal transplant Candida keratitis – Incidence and outcome
title_fullStr Post-corneal transplant Candida keratitis – Incidence and outcome
title_full_unstemmed Post-corneal transplant Candida keratitis – Incidence and outcome
title_short Post-corneal transplant Candida keratitis – Incidence and outcome
title_sort post-corneal transplant candida keratitis – incidence and outcome
topic Special Focus, Cornea, Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9023991/
https://www.ncbi.nlm.nih.gov/pubmed/35086233
http://dx.doi.org/10.4103/ijo.IJO_560_21
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