ESCRS 2025: Cornea Infectious Disease
Clinical Patterns of Fungal Keratitis at Moorfields Eye Hospital: A 10-Year Observational Longitudinal Study (2013-2023)
Presenter: Giulia Firmani
A retrospective review at Moorfields Eye Hospital, UK, examined trends in fungal keratitis (FK) over 2013–2023, identifying 177 cases (median age 60.5 years, 42% male). Diagnosis was confirmed by corneal culture, polymerase chain reaction (PCR), corneal biopsy, or in vivo confocal microscopy (IVCM), with 39.5% diagnosed clinically.
Filamentous fungi accounted for 20.9% of cases, yeasts for 37.3%, and mixed infections for 1%. Contact lens use was the main risk for filamentary FK. Nearly half of cases lost vision to 6/60 or worse, and 39% required penetrating keratoplasty. Yeasts, now the most common FK cause, reflect a shift from earlier filamentous predominance, likely due to more cases linked to ocular surface disease and steroid use (71%).
Clinical and Microbiological Outcomes of Infectious Keratitis in Patients with Type 2 Diabetes Mellitus: A Retrospective Analysis
Presenter: Or Ben-Shaul
A retrospective analysis at Carmel Medical Center (2013–2020) assessed 853 patients with infectious keratitis for the impact of type 2 diabetes mellitus (T2DM) on disease severity, culture positivity, and microbial patterns. T2DM significantly increased the risk of severe keratitis requiring tectonic keratoplasty (OR = 2.50, p = 0.016) and positive microbial cultures (OR = 2.52, p = 0.012).
Age and gender were not significant risk factors for severe outcome. While T2DM patients showed a non-significant trend toward more Gram-positive infections, Streptococcus pneumoniae was most common among them, whereas Pseudomonas aeruginosa prevailed in non-diabetics. Careful management is warranted in T2DM patients with infectious keratitis.
Safety and Efficacy of Topical Corticosteroid in Bacterial Keratitis: A Systematic Review
Presenter: Aulia Kezia Mulyazhara
A systematic review following the PRISMA Statement examined the safety and efficacy of topical corticosteroids in bacterial keratitis across five studies. Findings were mixed: high-dose corticosteroids sometimes improved vision, but in Pseudomonas aeruginosa keratitis, they delayed healing and worsened outcomes.
Non-Nocardia ulcers had minor visual improvement with corticosteroids, while Nocardia ulcers developed larger scars. Overall, there were no significant differences in transplant rates, vision loss, recurrence, or final results between corticosteroid and non-corticosteroid groups. Topical corticosteroids may slightly slow healing but do not worsen patient outcomes or increase adverse effects, and their safety depends on the specific bacterial etiology.
Ref: European Society of Cataract and Refractive Surgeons (ESCRS) Congress 2025, September 12-16, Denmark
