{"title":"Outcomes of Fungal Corneal Ulcer with Impending Perforation after Temporary Suture Tarsorrhaphy.","authors":"Sumit Singh Maharjan, Aashish Raj Pant, Purushottam Joshi, Pranav Shrestha, Ranjana Sharma","doi":"10.3126/nepjoph.v14i1.37965","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to evaluate outcomes and complications of temporary suture tarsorrhaphy (TST) in cases of impending corneal ulcer perforation.</p><p><strong>Materials and methods: </strong>Case records of patients who underwent temporary suture tarsorrhaphy at Mechi Eye Hospital during a period of 18 months were retrospectively evaluated. All the smear positive fungal keratitis with more than 5mm infiltration involving central and/or paracentral cornea with impending corneal perforation were included. Demographic and clinical profile including - visual acuity, indication for temporary suture tarsorrhaphy, duration of signs and symptoms were noted. The outcomes were evaluated after 1 month and 3 months post tarsorrhaphy, in relation with time to epithelial healing, anatomical success rate, best corrected visual acuity, complications associated with non-healing corneal ulcer, number of temporary suture tarsorrhaphy needed and complications of TST.</p><p><strong>Results: </strong>The study included 119 cases of smear positive fungal keratitis with mean age of 51.34 + 15.56 years. In this study, 56.30% of the patients developed epithelial healing at 2 - 4 weeks with mean duration of 23.24 + 12.09 days of temporary suture tarsorrhaphy. Out of 119 patients, the corneal ulcer healed in 84 patients (70.6%), whereas 35 (29.4%) did not heal. Among those with non-healing ulcers, 15 patients (12.6%) had to undergo evisceration. The anatomical success rate was 87.39% which was statistically significant (P = 0.001). Regarding visual outcome, in 62 patients (52.10%) BCVA improved by 2 or more lines, which was statistically significant (P<0.05) resulting in a functional success of 26.89%.</p><p><strong>Conclusion: </strong>This study concludes that temporary suture tarsorrhaphy could be a useful option for management of corneal ulcers with impending perforation in eye centers with limited resources settings and high disease burden with good anatomical and functional outcome.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"14 27","pages":"72-81"},"PeriodicalIF":0.3000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nepalese Journal of Ophthalmology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3126/nepjoph.v14i1.37965","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: This study aims to evaluate outcomes and complications of temporary suture tarsorrhaphy (TST) in cases of impending corneal ulcer perforation.
Materials and methods: Case records of patients who underwent temporary suture tarsorrhaphy at Mechi Eye Hospital during a period of 18 months were retrospectively evaluated. All the smear positive fungal keratitis with more than 5mm infiltration involving central and/or paracentral cornea with impending corneal perforation were included. Demographic and clinical profile including - visual acuity, indication for temporary suture tarsorrhaphy, duration of signs and symptoms were noted. The outcomes were evaluated after 1 month and 3 months post tarsorrhaphy, in relation with time to epithelial healing, anatomical success rate, best corrected visual acuity, complications associated with non-healing corneal ulcer, number of temporary suture tarsorrhaphy needed and complications of TST.
Results: The study included 119 cases of smear positive fungal keratitis with mean age of 51.34 + 15.56 years. In this study, 56.30% of the patients developed epithelial healing at 2 - 4 weeks with mean duration of 23.24 + 12.09 days of temporary suture tarsorrhaphy. Out of 119 patients, the corneal ulcer healed in 84 patients (70.6%), whereas 35 (29.4%) did not heal. Among those with non-healing ulcers, 15 patients (12.6%) had to undergo evisceration. The anatomical success rate was 87.39% which was statistically significant (P = 0.001). Regarding visual outcome, in 62 patients (52.10%) BCVA improved by 2 or more lines, which was statistically significant (P<0.05) resulting in a functional success of 26.89%.
Conclusion: This study concludes that temporary suture tarsorrhaphy could be a useful option for management of corneal ulcers with impending perforation in eye centers with limited resources settings and high disease burden with good anatomical and functional outcome.