TY - JOUR
T1 - Postkeratoplasty Atopic Sclerokeratitis in Keratoconus Patients
AU - Tomita, Machiko
AU - Shimmura, Shigeto
AU - Tsubota, Kazuo
AU - Shimazaki, Jun
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/5
Y1 - 2008/5
N2 - Purpose: To estimate the incidence of and investigate possible risk factors for postkeratoplasty atopic sclerokeratitis in keratoconus patients undergoing keratoplasty. Design: Retrospective, noncomparative, interventional case series. Participants: Two hundred forty-seven eyes with keratoconus. Methods: We reviewed the medical records of all keratoplasty cases of keratoconus between May 2000 and December 2005 at Tokyo Dental College Ichikawa General Hospital. The incidence and clinical details of cases consistent with postkeratoplasty atopic sclerokeratitis were recorded. Main Outcome Measures: Cases with acute sclerokeratitis during the early postoperative period were retrospectively evaluated. Results: A total of 247 keratoconus eyes were followed at our clinic after keratoplasty (mean follow-up, 18.5±13.0 months). Thirty-five eyes of 29 patients (14.2%) had a history of atopic dermatitis, of which 6 eyes of 5 patients (2.4%) developed postkeratoplasty atopic sclerokeratitis. Mean age of postkeratoplasty atopic sclerokeratitis patients was 29 years (range, 23-39). The mean period between keratoplasty and onset of postkeratoplasty atopic sclerokeratitis was 26 days (range, 11-41). Loosening of running sutures and wound leakage were observed in 3 eyes; persistent epithelial defects in 3 eyes; and graft melting in 2 eyes, 1 of which was perforated. Preoperative atopic blepharitis and corneal neovascularization were identified as risk factors for postkeratoplasty atopic sclerokeratitis. Conclusions: Postkeratoplasty atopic sclerokeratitis is a potentially severe complication in atopic patients undergoing keratoplasty. Systemic immunosuppression may be considered in patients with active blepharitis and corneal neovascularization.
AB - Purpose: To estimate the incidence of and investigate possible risk factors for postkeratoplasty atopic sclerokeratitis in keratoconus patients undergoing keratoplasty. Design: Retrospective, noncomparative, interventional case series. Participants: Two hundred forty-seven eyes with keratoconus. Methods: We reviewed the medical records of all keratoplasty cases of keratoconus between May 2000 and December 2005 at Tokyo Dental College Ichikawa General Hospital. The incidence and clinical details of cases consistent with postkeratoplasty atopic sclerokeratitis were recorded. Main Outcome Measures: Cases with acute sclerokeratitis during the early postoperative period were retrospectively evaluated. Results: A total of 247 keratoconus eyes were followed at our clinic after keratoplasty (mean follow-up, 18.5±13.0 months). Thirty-five eyes of 29 patients (14.2%) had a history of atopic dermatitis, of which 6 eyes of 5 patients (2.4%) developed postkeratoplasty atopic sclerokeratitis. Mean age of postkeratoplasty atopic sclerokeratitis patients was 29 years (range, 23-39). The mean period between keratoplasty and onset of postkeratoplasty atopic sclerokeratitis was 26 days (range, 11-41). Loosening of running sutures and wound leakage were observed in 3 eyes; persistent epithelial defects in 3 eyes; and graft melting in 2 eyes, 1 of which was perforated. Preoperative atopic blepharitis and corneal neovascularization were identified as risk factors for postkeratoplasty atopic sclerokeratitis. Conclusions: Postkeratoplasty atopic sclerokeratitis is a potentially severe complication in atopic patients undergoing keratoplasty. Systemic immunosuppression may be considered in patients with active blepharitis and corneal neovascularization.
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U2 - 10.1016/j.ophtha.2007.07.018
DO - 10.1016/j.ophtha.2007.07.018
M3 - Article
C2 - 17884169
AN - SCOPUS:42649106480
VL - 115
SP - 851
EP - 856
JO - Ophthalmology
JF - Ophthalmology
SN - 0161-6420
IS - 5
ER -