Therapeutic Keratoplaty for Advanced uppurative Keratiti Original Reearch Article

Purpoe To determine indication, therapeutic ucce, and corneal tranplantation technique for advanced medically uncontrolled infectiou keratiti. Deign Retropective, interventional cae erie. Method A review of 92 conecutive patient (1991 to 2002) who underwent therapeutic keratoplaty for acute infectiou keratiti performed at ingapore National Eye Centre. Cauative organim() were identified and outcome were evaluated in term of infectiou cure (therapeutic ucce), graft clarity, and viual acuity. Reult Peudomona aeruginoa (58.7%) and Fuarium pecie (32.3%) were the predominant organim for bacterial and fungal keratiti, repectively. Keratoplaty type included penetrating keratoplaty (PK; n = 80) and lamellar keratoplaty (n = 12). Mean graft diameter wa 9.5 mm (range, 5.5 to 14 mm). eventy-four patient (80.4%) achieved therapeutic ucce after one keratoplaty procedure, three patient were cured after a econd keratoplaty. Life-table urvival analyi computed the one-year therapeutic urvival for bacterial and fungal keratiti a 76.6% and 72.4%, repectively (P = .76). The Kaplan-Meier one-year urvival rate for PK optical clarity wa 72%. Twenty-two patient underwent repeat keratoplaty for variou reaon (optical, n = 8; recurrent primary infection, n = 7; perforation or ubequent new infection, n = 7). Of the 15 patient for whom therapy failed, 11 had fungal keratiti. Infection recurrence time wa four day to one year. Mot recurrence (n = 11) appeared within ix week after urgery. Concluion Therapeutic keratoplaty may treat evere, refractory infectiou keratiti effectively. High cure rate are achievable, although infection recurrence depite prolonged treatment remain a ignificant problem in fungal keratiti.