Chhaya Ashok Shinde1, Prashant Sarjerao Ghorpade2
Therapeutic penetrating keratoplasty for corneal infections restores anatomical integrity. Improvement in instrumentation and surgical techniques, better postoperative management have improved corneal transplant outcome. Purpose of the study was to know what are the anatomical and visual results after therapeutic keratoplasty and to judge what could be the factors affecting the results.
MATERIALS AND METHODS
Prospective, non-comparative, observational cohort study was done in 56 patient (56 eyes) operated for therapeutic penetrating keratoplasty at tertiary care institute .Patients were reviewed for demographic data, postoperative best-corrected visual acuity, graft clarity, and complications. Pre-operative treatment in bacterial infections included Cefazolin 50 mg/ml and Tobramycin 1.4 % or gentamicin 1.4% half hourly, 1% atropine drops. Fungal infections were treated with Natamycin 5% suspension. Debridement was done. Amphotericin B was used against yeasts. Voriconazole (1%) eye drops were given in Aspergillus species. With full aseptic precautions penetrating keratoplasty was carried out. The graft was 0.5 mm larger than the lesion. Keratoplasties were evaluated for (1) Graft clarity at 1 month and 1 year postoperative. (2) Cure of the infectious disease after surgery. (3) Anatomical success rate and visual results.
At the end of one year clear graft with bacterial keratitis was seen in 23 eyes (74.19%) out of 31 eyes. In fungal keratitis clear graft was seen in 10 eyes (45.45%) out of 22 eyes. 48.22% patients had vision of FC 1m-6/60 compared to preoperative vision at the end of one year. At the end of one year anatomical integrity was maintained in 53 (94.64%) cases and it was lost in 5.36% patients.
Patients who underwent keratoplasty with 7.5 mm graft size had maximum graft clarity at the end of one year. Graft was clear in 36 patients (64.29%) out of total 56 patients. At the end of 1 year vision improved to FC 1 mt - 6/60 in 48.22% patients.
Therapeutic Keratoplasty, Bacterial Infections, Fungal Keratitis, Graft Clarity, Anatomical Integrity.