Therapeutic penetrating keratoplaty for microbial keratiti in Taiwan from 1987 to 2001

Purpoe To determine the urgical outcome of therapeutic penetrating keratoplaty (PKP) and it role in the management of microbial keratiti. Deign Interventional cae erie. Method We retropectively performed a chart review of the hopital record of all 151 patient undergoing therapeutic PKP for culture-proven microbial keratiti at the National Taiwan Univerity Hopital during a 14 year-period (1987–2001). Patient were divided into three categorie: (1) bacterial keratiti; (2) fungal keratiti; and (3) acanthamoebic keratiti. Each of the following criteria wa evaluated: (1) graft clarity 1 month and 1 year potoperatively; (2) cure of the dieae; and (3) anatomical ucce rate. Reult A total of 108 therapeutic PKP met the criteria. Therapeutic PKP eradicated the infection in 37/41 of patient with bacterial keratiti, 36/52 of patient with fungal keratiti, and 13/15 of patient with acanthamoebic keratiti. 22/32 of graft of bacterial keratiti, 20/39 of fungal keratiti, and 11/14 of acanthamoebic keratiti remained clear at 1 year potoperatively. A higher percentage of graft clarity at 1 year potoperatively wa achieved in all three categorie when graft were 8.5 mm or le compared with larger graft. All five patient with econdary endophthalmiti oberved at the time of therapeutic PKP experienced a progreion of infection depite aggreive urgical treatment, and had to be enucleated. Concluion Therapeutic PKP i valuable in the management of microbial keratiti that i unreponive to medical therapy. A higher percentage of clear graft wa found when graft were maller in all three categorie. urgical reult are wore for patient with fungal keratiti, regardle of graft clarity, anatomical ucce, or infection eradication rate.