Corneal transplantation strategies for Acanthamoeba Keratitis: A systematic review and meta-analysis

IF 4.8 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2026-03-01 Epub Date: 2025-12-17 DOI:10.1016/j.jiph.2025.103114

Shangyang Jiang , Leying Wang , Zijun Zhang, Zhenyu Wei, Kai Cao, Qingfeng Liang

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引用次数: 0

Abstract

Acanthamoeba keratitis (AK) is an uncommon yet vision-threatening corneal infection, and the lack of an international consensus on its surgical management often complicates clinical decision-making. To address this gap, a comprehensive literature review was conducted across PubMed, EMBASE, Web of Science, and the Cochrane Library from database inception to July 1, 2025, focusing on clinical studies that reported outcomes of keratoplasty. The analysis included 24 studies encompassing 487 eyes and compared different keratoplasty techniques, specifically therapeutic penetrating keratoplasty (TPK), optical penetrating keratoplasty (OPK), and therapeutic deep anterior lamellar keratoplasty (TDALK). The data indicated that Acanthamoeba infection control sufficient to permit OPK was associated with the most favorable results. In eyes with infection confined to the anterior stroma and thus eligible for TDALK, graft survival was higher and postoperative complications were fewer. In cases with persistent full-thickness infection, TPK was required and was associated with poorer visual recovery and higher rates of graft failure, recurrent infection, and regrafting.

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棘阿米巴角膜炎的角膜移植策略：系统回顾和荟萃分析

棘阿米巴角膜炎（AK）是一种罕见但威胁视力的角膜感染，其手术治疗缺乏国际共识，往往使临床决策复杂化。为了解决这一差距，我们对PubMed、EMBASE、Web of Science和Cochrane图书馆从数据库建立到2025年7月1日进行了全面的文献综述，重点关注报道角膜移植结果的临床研究。该分析包括24项研究，涵盖487只眼睛，并比较了不同的角膜移植技术，特别是治疗性穿透性角膜移植（TPK）、光学穿透性角膜移植（OPK）和治疗性深前板层角膜移植（TDALK）。数据表明，棘阿米巴感染控制足以允许OPK与最有利的结果相关。在感染局限于前基质的眼睛中，适合进行TDALK，移植物存活率较高，术后并发症较少。在持续性全层感染的病例中，TPK是必需的，并且与较差的视力恢复和较高的移植物失败、复发感染和再移植率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.