Title: Outcome of Therapeutic Penetrating Keratoplasty in infective keratitis at a Tertiary Eye Hospital
Author: Dr Rishi Gupta, M.S.
DOI: https://dx.doi.org/10.18535/jmscr/v7i5.18
Abstract
Objective: To find out the outcome of therapeutic keratoplasty in infective keratitis.
Methods: Medical records of patients, who underwent therapeutic keratoplasty from January 2017 to January 2018, were reviewed retrospectively. Data collected included demographic parameters, indications for surgery, microbiology of the ulcers and donor tissue details. In the follow-up period, ocular status was evaluated in terms of eradication of disease, anatomic success, graft clarity, visual acuity, and development of glaucoma and cataract.
Results: 90 eyes of 90 patients were enrolled in the study. Male and female ratio in present study was 3:2. Average age was 45.4±13.7 years. Overall, 71%( 64) of infective keratitis was perforated on presentatioin. A total of 51 (56.6%) eyes were positive for organisms of which 25 showed pure fungus, 24 showed pure bacteria and 2 showed mixed infection. The commonest fungus and bacteria isolated were Aspergillus and Streptococcus, respectively. Average follow-up period was 11±2.3 months. Overall cure rate of infection was 88.8%, anatomical success rate was 90%, and graft clarity was 36.6%. Overall, 43.3% had secondary glaucoma. In the postoperative course, 66.6% of phakic eyes had developed cataract. Overall functional success with a visual acuity above 6/60 was 25.5%. Bacterial keratitis had a significantly higher cure rate, anatomical success, and graft clarity compared to fungal keratitis.
Conclusion: Therapeutic keratoplasty is an important procedure to save the eye and preserve vision in severe infective keratitis. There is a high incidence of postoperative glaucoma, cataract, and graft failure in such a surgery. Bacterial keratitis has a better outcome than fungal keratitis.
Keywords: Therapeutic penetrating keratoplasty, Infective keratitis, Fungal keratitis.
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