EPIDEMIOLOGY AND OUTCOME OF CORNEAL ULCER IN YAZD SHAHID SADOUGHI HOSPITAL

Abstract- The objectives of this study were to define the clinical risk factors, microbiological spectrum, and visual outcome of bacterial keratitis at Shahid Sadoughi Hospital (Yazd, Iran). A cross-sectional prospective study, identified 80 cases of microbial keratitis from March 1999 to March 2001. Inclusion criteria were presence of corneal stromal infiltrate in slit lamp examination, and microbiologic evaluation of corneal scrapings. Clinical features, risk factors, VA were analyzed. The mean (±SD) age of patients was 45.3 years (±18.50) with a range of 3 to 79 years. Forty-six (57.5%) patients were male and (42.5%) female. The predominant predisposing factors were corneal trauma (39%), ocular diseases (34.1%), previous ocular surgery (10%) and use of contact lens (9.8%). Forty percent of cases were culture- positive. Staphylococcus epidermis (21.9%), Staphylococcus aureus (18.8%) and Streptococcus pneumonia (15.6%) were the most common isolates. Fungi were isolated in five eyes. Twenty-nine patients (36.2%) achieved VA of 20/120 or better at the final follow-up. Fourteen eyes (17.5%) required surgery and 4 eyes (5%) eventually needed evisceration. Microbial keratitis resulting in loss of the eye occurred typically in elderly patients, with pre-existing poor VA and delayed treatment. This study illustrated that the epidemiology of corneal ulcer in this area is different from what is observed in other parts of the world