Penetrating Keratoplasty for Corneal Perforations in Fungal Keratitis

Abstract

To evaluate the complications and therapeutic effects of penetrating keratoplasty (PKP) in the treatment of corneal perforations in fungal keratitis. The medical records of patients who underwent PKP for corneal perforations in fungal keratitis at Shandong Eye Institute from January 1999 to December 2004 were retrospectively reviewed. Fifty-two patients (52 eyes) were included in this study. Twenty eyes (38.5%) had graft rejection after primary PKP, 12 of which were medically treated, and 8 underwent secondary PKP with 4 acquiring clear grafts. Fungal infection recurred in 8 eyes (15.4%), 3 of which were controlled with antifungal agents, 3 were treated with secondary PKP, and 2 were enucleated. Ten eyes (19.2%) with complicated cataract underwent intraoperative or postoperative extracapsular cataract extraction. Seven eyes (13.5%) with secondary glaucoma were cured. Graft ulcer occurred in 5 eyes (9.6%), 3 of which were cured with amniotic membrane transplantation and 2 with medications. Forty-four grafts (84.6%) remained clear at final follow-up, and 46 eyes (88.5%) had improved visual acuity. Although many complications may occur, therapeutic PKP seems to be effective in the treatment of fungal keratitis with corneal perforation.