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Ulcerative keratitis in bullous keratopathy
J I Luchs1, E J Cohen, C J Rapuano
1Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107, USA.
Ophthalmology
|May 1, 1997
Summary
Bullous keratopathy (BK) patients face a 4.7% risk of ulcerative keratitis. Steroid use, bandage contact lenses, and bullae significantly increase this risk, while prophylactic antibiotics do not prevent it.
Area of Science:
- Ophthalmology
- Corneal Disease
- Infectious Keratitis
Background:
- Bullous keratopathy (BK) is a condition characterized by fluid-filled blisters on the cornea.
- Understanding risk factors for ulcerative keratitis in BK patients is crucial for preventing vision loss.
Observation:
- A retrospective review of 918 patients with pseudophakic or aphakic BK was conducted.
- The study analyzed the incidence of ulcerative keratitis and the roles of bullae, bandage soft contact lenses, steroids, and prophylactic antibiotics.
Findings:
- Ulcerative keratitis occurred in 4.7% of BK patients.
- Steroids (P < 0.0001), bandage soft contact lens use (P = 0.004), and the presence of bullae (P = 0.01) were independent risk factors for ulcerative keratitis.
- The combination of steroids and bandage lenses posed the highest risk (P < 0.001). Paradoxically, prophylactic antibiotics showed a significant association with ulcerative keratitis (P = 0.01).
Implications:
- Prolonged BK duration is a risk factor for infection.
- Ophthalmologists should carefully consider steroid use and bandage contact lens prescriptions in BK patients due to increased ulcer risk.
- Prophylactic antibiotic use may not be effective in preventing ulcerative keratitis in this population.