Excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay for recalcitrant filamentary fungal keratitis: A retrospective comparative clinical data analysis

Yingxin Chen, Minghong Gao, Joshua K. Duncan, Di Ran, Denise Roe, Michael W Belin, Mingwu Wang

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

The aim of the present study was to investigate the efficacy of a novel surgical intervention, excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay (EKCAI), for the treatment of recalcitrant filamentary fungal keratitis. A retrospective analysis was performed of patients who underwent excisional keratectomy combined with conjunctival flap inlay (EKCFI), EKCAI or therapeutic penetrating keratoplasty (TPK) from January 2006 to January 2011. Recalcitrance was determined as being unresponsive to standard medical antifungal therapy for at ≥1 week. Outcome measures among the three intervention modalities were compared. A total of 128 patients had a follow-up of ≥1 year after the primary intervention. The success rates of interventions at 1-year follow-up were 58.33% in the EKCFI group, 88.37% in the EKCAI group and 93.44% in the TPK group (P<0.0002). The preoperative visual acuity of the three groups were similar (P=0.6458), while the postoperative best-corrected visual acuity (BCVA) of patients without recurrence was significantly different among the three groups 3 months after surgery. The best postoperative BCVA was found in the TPK group, while the worst was in the EKCFI group. In conclusion, EKCAI does not require donor cornea, is straightforward surgically, and has a favorable success rate compared with EKCFI.

Original languageEnglish (US)
Pages (from-to)3014-3020
Number of pages7
JournalExperimental and Therapeutic Medicine
Volume12
Issue number5
DOIs
StatePublished - Nov 1 2016

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Keywords

  • Amniotic membrane inlay
  • Conjunctival flap
  • Cryotherapy
  • Refractory fungal keratitis
  • Therapeutic keratoplasty

ASJC Scopus subject areas

  • Medicine(all)
  • Immunology and Microbiology (miscellaneous)
  • Cancer Research

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