Outcome of therapeutic penetrating keratoplasty in infectious keratitis

Ophthalmic Surg Lasers Imaging. Jul-Aug 2005;36(4):303-9.

Abstract

Background and objective: To study the outcome of therapeutic penetrating keratoplasty in eyes with microbial keratitis.

Patients and methods: A prospective database on 134 therapeutic cornea transplants in 134 patients recorded demographic details on age and gender of the patient, indication for surgery, size of the donor and recipient bed, graft clarity, complications, and residual morbidity. Patients included in this analysis had a minimum follow-up of 1 year. All patients underwent therapeutic penetrating keratoplasty by a similar method that involved a donor button that was oversized by 0.5 mm and 16 bites of interrupted sutures.

Results: Most of the 134 ulcers needing therapeutic grafts were bacterial (n = 54) or fungal (n = 54). One hundred eighteen eyes had perforation at presentation. One hundred six (90%) of the therapeutic grafts achieved anatomical success. The most common complication of glaucoma occurred in 22% of eyes with presurgical perforated ulcers and 1% of nonperforated ulcers. Persistent epithelial defects were significantly more frequent in grafts of 9 mm or more (P = .05).

Conclusions: Our results confirm that therapeutic penetrating keratoplasty for infections is successful in restoring anatomic integrity in most eyes.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Corneal Ulcer / microbiology
  • Corneal Ulcer / surgery*
  • Eye Infections, Bacterial / microbiology
  • Eye Infections, Bacterial / surgery*
  • Eye Infections, Fungal / microbiology
  • Eye Infections, Fungal / surgery*
  • Female
  • Humans
  • Keratoplasty, Penetrating*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prospective Studies
  • Tissue Donors
  • Treatment Outcome
  • Visual Acuity