European Journal of Cardiovascular Medicine

Introduction: Corneal ulcers, characterized by epithelial loss, stromal infiltration, suppuration, and inflammation, pose a global health concern, especially in the context of corneal blindness. Infectious keratitis, attributed to microbial agents, is a leading cause of corneal ulcers. This study focuses on the incidence, microbial etiology, and management strategies for corneal perforations arising from infectious keratitis. Objective: To investigate the incidence of corneal perforation in cases of infective keratitis, identify specific microorganism groups associated with corneal perforations, determine appropriate treatment modalities, and assess the prognosis of various interventions in perforated corneal ulcer management. Materials and Methods: A total of 150 patients with infectious perforated corneal ulcers were enrolled. Inclusion criteria covered patients aged 18 to 60 years, irrespective of gender, with infectious etiology. A comprehensive clinical examination, microbiological analysis, and various treatment modalities, including Bandage Contact Lens, Cyanoacrylate Glue, Amniotic Membrane Transplantation, and Corneal Transplantation, were employed. Results: Prevalence is observed in the age group of 25-50 years (70 patients), followed by 50-60 years (53 patients), and 18-25 years (27 patients). There is a significant male preponderance (117 cases) compared to females (33 cases). There is a higher incidence among farmers (44 cases) and laborers (27 cases), suggesting potential occupational risk factors. Paracentral perforations are the most prevalent (71 cases), followed by central (45 cases), and peripheral perforations (34 cases). A total of 132 positive cases indicate a predominantly infectious etiology. There is a higher prevalence of bacterial infections (75 cases), followed by fungal (29 cases), and mixed infections (28 cases). Micro perforations (<1mm) are the most common (68 cases), followed by small (59 cases), and large perforations (23 cases). Bandage Contact Lens (67 cases), Amniotic Membrane Transplantation (45 cases), and Penetrating Keratoplasty (38 cases) are frequently employed. Discussion:   Infectious keratitis, if not promptly managed, poses severe complications. Factors such as occupation, accessibility to medications, and gender influence delayed presentations. Corneal perforation, a consequence of various corneal disorders, requires timely recognition and intervention to prevent vision loss. Treatment modalities include medical approaches, tissue adhesives, and various surgical interventions. Conclusion:  The study underscores the multifaceted approach required for infectious keratitis management. Prompt intervention, gender-specific prevalence, and the efficacy of diverse treatments based on perforation characteristics are highlighted. The findings contribute valuable insights for the effective management of corneal perforations arising from infective keratitis.