American journal of ophthalmology · 2025
Clinical Outcomes and Predictive Factors for Penetrating Keratoplasty Following Glue Application for Corneal Perforation and Thinning.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Agarwal Manokamna, Huang Ryan S, Mimouni Michael, Rootman David S, Chan Clara C
Аннотация
PURPOSE: To describe the clinical outcomes and identify predictive factors associated with the need for penetrating keratoplasty (PKP) following cyanoacrylate tissue adhesive (CTA) application for corneal perforation or thinning.
DESIGN: Retrospective clinical cohort study.
METHODS: We conducted a single-center, retrospective cohort study of 189 eyes treated with CTA for corneal thinning or perforation between January 2006 and August 2024 at a tertiary care center. The primary outcome was the best-corrected visual acuity (BCVA) at final follow-up. Univariable and multivariable logistic regression models were used to identify associations between baseline and clinical characteristics with progression to PKP following CTA management.
RESULTS: Of 189 eyes treated with CTA, 64 (34%) underwent subsequent PKP after CTA application. Multivariable regression identified several independent predictors of needing PKP, including central or paracentral defect location (vs peripheral, OR = 2.98, 95% CI = 1.27-6.91, P = .012), multiple CTA applications (vs single, OR = 2.70, 95% CI = 1.42-5.15, P = .003), worse baseline BCVA (logMAR >2 vs logMAR <1; OR = 3.10, 95% CI = 1.35-6.58, P = .005), and viral keratitis (OR = 3.55, 95% CI = 1.21-9.58, P = .020). Trauma was associated with lower odds of PKP (OR = 0.26, 95% CI = 0.08-0.80, P = .014). Median final BCVA following PKP was 2.0 logMAR (IQR: 1.5-2.3), with no significant difference from baseline (P = .585).
CONCLUSION: PKP remains an important intervention for eyes refractory to CTA; however, final visual outcomes are limited. Early identification of high-risk clinical features may help guide timely decision-making and set realistic expectations regarding prognosis.
DESIGN: Retrospective clinical cohort study.
METHODS: We conducted a single-center, retrospective cohort study of 189 eyes treated with CTA for corneal thinning or perforation between January 2006 and August 2024 at a tertiary care center. The primary outcome was the best-corrected visual acuity (BCVA) at final follow-up. Univariable and multivariable logistic regression models were used to identify associations between baseline and clinical characteristics with progression to PKP following CTA management.
RESULTS: Of 189 eyes treated with CTA, 64 (34%) underwent subsequent PKP after CTA application. Multivariable regression identified several independent predictors of needing PKP, including central or paracentral defect location (vs peripheral, OR = 2.98, 95% CI = 1.27-6.91, P = .012), multiple CTA applications (vs single, OR = 2.70, 95% CI = 1.42-5.15, P = .003), worse baseline BCVA (logMAR >2 vs logMAR <1; OR = 3.10, 95% CI = 1.35-6.58, P = .005), and viral keratitis (OR = 3.55, 95% CI = 1.21-9.58, P = .020). Trauma was associated with lower odds of PKP (OR = 0.26, 95% CI = 0.08-0.80, P = .014). Median final BCVA following PKP was 2.0 logMAR (IQR: 1.5-2.3), with no significant difference from baseline (P = .585).
CONCLUSION: PKP remains an important intervention for eyes refractory to CTA; however, final visual outcomes are limited. Early identification of high-risk clinical features may help guide timely decision-making and set realistic expectations regarding prognosis.