Outcomes of Therapeutic Penetrating Keratoplasty

Authors

  • Sujata Ghimire Bhandari Consultant Ophthalmologist, Nepal Eye Hospital, Kathmandu, Nepal,
  • Reeta Gurung Consultant Ophthalmologist, Tilganga Eye Centre, Kathmandu, Nepal,
  • Leena Bajracharya Associate Professor, National Academy of Medical Sciences, Tilganga Eye Centre, Kathmandu, Nepal

Keywords:

Integrity, Therapeutic penetrating Keratoplasty, Ulcer

Abstract

INTRODUCTION: Infective corneal ulcer is the leading cause of blindness second to cataract in developing world. The purpose of this study was to assess the outcome of therapeutic penetrating keratoplasty in corneal ulcers non- responding to microbial therapy.

METHOD: This was a prospective study conducted from January 2007 to December 2007 at Tilganga Eye Centre, Kathmandu in 50 patients with corneal ulcers with perforation or impending perforation who were not responding to microbial therapy.

RESULT: Out of 50 patients, 29 were female (27-68 years) and 21 were male (16-74 years). All patients were on topical antibiotics before presentation. Despite the use of topical antibiotics, 43 eyes were culture positive and 7 were culture negative. After therapeutic penetrating keratoplasty (TPK), 47 (94%) patients maintained structural integrity of the eyeball. Twenty five patients who presented earlier (0-4 weeks) maintained structural integrity with a visual acuity ranging from 6/9-5/60 in comparison to patients with late presentation (>1-6 months). Three (6%) patients after developing endophthalmitis underwent evisceration. Six (12%) patients had shallow anterior chamber (AC), 4 (8%) patients had persistent epithelial defect and 3 (6%) patients had rejection as early complications. Late complications were cataract in 44 (88%), glaucoma in 32(64%) and graft failure in 13(26%) patients.

CONCLUSION: TPK is successful in restoring anatomic integrity for infectious corneal ulcers in most of the eyes.

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Published

2020-12-25

Issue

Section

Orginal Articles