[Optical penetrating keratoplasty in eyes with severe keratomycosis after therapeutic keratoplasty]

Abstract

Objective: To observe and evaluate secondary optical penetrating keratoplasty (PKP) in the eyes with severe keratomycosis after therapeutic keratoplasty using cryopreserved donor tissue.

Method: There were 35 eyes in 35 cases for whom therapeutic PKP using cryopreserved donor tissue had been carried out to treat severe fungal keratitis. At least 6 months after the PKP, when the fungal infection had been eradicated and ocular inflammation had resolved, a secondary optical penetrating keratoplasty was further performed for visual rehabilitation. If the crystal lens was found to be opaque, it was also simultaneously removed through extracapsular cataract removal with an IOL implantation. Surgical or postoperative complications, visual outcome, graft rejection episode, and graft survival were analyzed.

Results: Among 35 eyes, 18 eyes received optical PKP only, and 17 received combined optical PKP with ECCE and IOL implantation. During the follow-up period of 6.8 - 36.8 (15.7 +/- 7.6) months after optical PKP, 3 eyes experienced graft failure due to immunologic rejection and 32 retained clear grafts. Postoperative visual acuity was 0.4 or better in 24 eyes, and 0.1 or better in 32 eyes, and less than 0.1 in 3 eyes.

Conclusions: Optical PKP performed in the eyes after therapeutic PKP due to severe fungal keratitis can recover satisfactory visual acuity, with low frequency of graft rejection, long-term graft survival and few complications.