Divya Palaksha1, Suresh Babu Gangasagara2, Raviprakash Durgappa3, Shivaprasad Reddy4
PURPOSE: To study the outcome of therapeutic penetrating keratoplasty (TPK) done for non-healing fungal keratitis.
METHODS: A retrospective interventional case study done on 25 fungal keratitis cases refractory to medical treatment. The outcome was measured in terms of maintenance of anatomical integrity, control of infection, visual acuity, graft clarity and complications.
RESULTS: Of the 25 cases studied, the most common indication for keratoplasty in our study was non-healing corneal ulcer [56%] followed by perforated corneal ulcer [28%]. The mean age of presentation was 52 yrs, 52% of patients were males and 48% were females. 9 cases [36%] gave a positive h/o injury with vegetative matter and 8[32%] cases gave h/o entry of foreign body. All patients in our study had pre-operative vision less than 1/60. Post operatively 88% had vision better than preoperative vision. Complications included epithelial defect in 10[40%] cases, 7[28%] cases had a recurrence of infection, 7[28%] had secondary glaucoma which were treated medically, 2[8%] had graft melt, 2[8%] had cataractous lens, 2[8%] had scleral abscess. Anatomical integrity was maintained in 23[92%] of our cases and graft clarity was maintained in 6[24%] cases.
CONCLUSION: The present study suggests that therapeutic keratoplasty in non-healing fungal ulcers helps in maintaining the anatomical integrity, decreases the infection load, improves vision as a secondary outcome, the patient can undergo an optical keratoplasty in future and prevents devastating complications.