Impact of COVID-19 Pandemic on Infectious Keratitis Outcomes: A Retrospective Multicenter Study in Tertiary Eye Hospitals of South India

Abstract

Purpose:The purpose of this study was to report the adverse effects of the COVID-19 pandemic on the clinical outcomes of infectious keratitis in South India.Methods: Two hundred fifty-eight patients presented with infectious keratitis at 6 tertiary care centers when strict travel restrictions were in place from March 24 to May 31, 2020. Case records were collected retrospectively and analyzed for demographics, type of initial treatment, length of delay in presentation, microbiological diagnosis, clinical course, and final treatment outcome. Results:The mean age of the patients was 49.2 years, with most of them (61.2%) being male. Forty-one patients (15.9%) did not receive any treatment for at least a week after the onset of symptoms. One hundred eight patients (41.9%) presented with severe ulcer (32 had a frank perforation). Resolution of the infection was achieved only in 103 patients (45.6%). A total of 90 patients (39.8%) with ulcers had a perforation, yet only 29 patients (32.2%) could receive keratoplasty because of the unavailability of donor tissues. At the end of 6-month follow-up, 47 patients had anatomical failure (loss of globe) and 12 additional patients had functional failure (total permanent vision loss).Conclusions: Delay in presentation and acute shortage of donor corneal tissues for emergency keratoplasty because of the COVID-19 pandemic had a grave impact, resulting in irreversible blindness in a significant number of patients.

Challenges in management of microbial keratitis during COVID-19 pandemic related lockdown: a comparative analysis with pre pandemic data

“…Our study was similar to a similar experience reported from South India on the outcomes of infectious keratitis. Our rate of resolution was lower (35.8%) compared to Christy et al (45.6%), this could be due to the higher incidence of severe keratitis in our study population (48.8% vs. 41.9%) [ 15 ].…”

Long-term outcomes of therapeutic corneal transplants performed in a tertiary eye care hospital in South India

“…Nearly 23% of patients with emergency corneal problems lost their vision permanently due to a lack of surgical intervention. [ 18 ] Based on our results, a significant portion of patients with infectious keratitis or trauma will need a repeat transplant at some point for optical clarity. Therefore, the use of glycerin-preserved corneas and gamma-irradiated grafts that can be preserved for 2 years at room temperature could be utilized in emergency situations to 1) allow the patient to undergo surgery sooner and 2) save the fresh tissue for optical purposes rather than therapeutic.…”

Demographic and microbiological profile of corneal ulcer patients presenting at a tertiary healthcare center of Eastern India during the COVID era: A hospital-based cross-sectional study

“…Table 5 summarizes various comparative and noncomparative studies on microbiological and demographic profile of corneal ulcers during COVID-19. [ 29 30 31 32 33 ] The current study is the only prospective study on demographic and microbiological profile of corneal ulcers during COVID-19 era.…”