Effect of Tectonic Penetrating Keratoplasty for Impending Perforation Due to Infectious Corneal Ulcer

ABSTRACT

PURPOSE: To investigate the effect of tectonic penetrating keratoplasty for the treatment of impending perforations caused by infectious corneal ulcers. METHODS: We analyzed preoperative and postoperative visual acuity, lesion location and size, graft size, postoperative outcome, and complications in 19 patients (19 eyes) with impending perforations due to infectious corneal ulcers. All patients underwent tectonic penetrating keratoplasty and had a minimum follow-up period of 6 months. RESULTS: In our study, eight eyes (42.1%) had herpes simplex keratitis, 6 eyes (31.6%) had bacterial keratitis, and 5 eyes (26.3%) had fungal keratitis. Twelve eyes had a lesion located in the central cornea, while 7 eyes had a lesion located in the paracentral cornea. Visual acuity improved in 13 eyes (68.4%) and anatomical success was achieved in 16 eyes (84.2%). Three eyes (15.8%) developed a graft melting secondary to rejection. Complications included bullous keratopathy (3 eyes, 15.8%), graft infection (3 eyes, 15.8%), neovascularization (2 eyes, 10.5%), and secondary glaucoma (1 eye, 5.3%). CONCLUSIONS: Tectonic penetrating keratoplasty maintains ocular integrity and effectively treats impending perforations caused by infectious corneal ulcers.