Surgical management of corneal perforation secondary to gonococcal keratoconjunctivitis

M. Kawashima, T. Kawakita, S. Den, M. Tomita, J. Shimazaki

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Aims: To report five cases of gonococcal keratoconjunctivitis with severe corneal involvement treated with therapeutic keratoplasty. Design: Retrospective case series. Methods: Five consecutive cases of gonococcal keratoconjunctivitis treated with keratoplasty for corneal perforation, with a mean age of 21.2 years, were analysed by patient's history, surgical approaches, and clinical outcomes, corrected visual acuity at initial visit and last follow-up. Results: All adult cases were originally diagnosed as epidemic keratoconjunctivitis by elsewhere, and corneal perforation occurred with a mean duration of 11 days after development of conjunctivitis. While laboratory tests revealed Neisseria gonorrhoeaein all five cases, three patients showed resistance to ofloxacin. Intensive medical treatment using penicillins and/or cephems was initiated. Two patients had peripheral corneal perforations, one had a paracentral perforation, and another, a large corneal perforation with stromal melting. One case had a central microcorneal perforation. In all cases, the anterior chamber was flat. Corneal perforations were treated with lamellar or penetrating keratoplasty using cryopreserved or fresh corneal grafts. All grafts remained clear during the mean follow-up period of 34.9 months. Final best-corrected visual acuity ranged from 20/60 to 20/16. Conclusions: Severe gonococcal keratoconjunctivitis can benefit from intensive surgical and medical intervention resulting in satisfactory visual rehabilitation.

Original languageEnglish
Pages (from-to)339-344
Number of pages6
JournalEye
Volume23
Issue number2
DOIs
Publication statusPublished - 2009
Externally publishedYes

Fingerprint

Corneal Perforation
Keratoconjunctivitis
Corneal Transplantation
Visual Acuity
Neisseria
Transplants
Penetrating Keratoplasty
Ofloxacin
Conjunctivitis
Anterior Chamber
Penicillins
Freezing
Rehabilitation
Therapeutics

Keywords

  • Corneal perforation
  • Gonococcal keratoconjunctivitis
  • Keratoplasty
  • Neisseria gonorrhoeae

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

Cite this

Kawashima, M., Kawakita, T., Den, S., Tomita, M., & Shimazaki, J. (2009). Surgical management of corneal perforation secondary to gonococcal keratoconjunctivitis. Eye, 23(2), 339-344. https://doi.org/10.1038/sj.eye.6703051

Surgical management of corneal perforation secondary to gonococcal keratoconjunctivitis. / Kawashima, M.; Kawakita, T.; Den, S.; Tomita, M.; Shimazaki, J.

In: Eye, Vol. 23, No. 2, 2009, p. 339-344.

Research output: Contribution to journalArticle

Kawashima, M, Kawakita, T, Den, S, Tomita, M & Shimazaki, J 2009, 'Surgical management of corneal perforation secondary to gonococcal keratoconjunctivitis', Eye, vol. 23, no. 2, pp. 339-344. https://doi.org/10.1038/sj.eye.6703051
Kawashima, M. ; Kawakita, T. ; Den, S. ; Tomita, M. ; Shimazaki, J. / Surgical management of corneal perforation secondary to gonococcal keratoconjunctivitis. In: Eye. 2009 ; Vol. 23, No. 2. pp. 339-344.
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