Outcome of penetrating keratoplasty in corneal ulcer: a single-center experience

Mohammad Reza Sedghipour, Rana Sorkhabi, Abdollah Shenasi, Hassan Dehghan
Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran

Background: Corneal ulcers often lead to scarring and astigmatism, and significant loss of vision is a common consequence.
Objective: To determine the rate of graft rejection, one of the most serious concerns with this procedure, and to evaluate the recovery of visual function in those patients for whom the operation was successful.
Methods: We describe a retrospective study of 33 corneal ulcer patients undergoing penetrating keratoplasty (PK) at the Tabriz Nikookari Eye Hospital.
Results: Mean age of the patients was 44 ± 14 years. Most common risk factors for active keratitis were trauma, dry eye, and malnutrition. Culture-positive results included bacterial keratitis (n = 15) and fungal keratitis (n = 5). Perforation was a significant risk factor for therapeutic failure (P < 0.05). Age or gender had no statistically significant effects on the PK outcome (P > 0.05). Postoperative visual acuity had a significant association with preoperative visual acuity (P < 0.01). Graft rejection rate (27.2%) was similar to that reported in the literature.
Conclusion: Although lamellar keratoplasty has recently been established, there are practical reasons for continuing the use of PK in centers such as ours, with due attention to the requirement for topical immunosuppression to diminish the rate of graft rejection and antimicrobial treatment to prevent postoperative infection.

Keywords: keratitis, ulcerative, graft rejection, perforation