Therapeutic penetrating keratoplasty in severe infective keratitis using glycerol-preserved donor corneas

摘要

PURPOSE: To report the surgical outcome of therapeutic penetrating keratoplasty (TPKP) using glycerol-preserved donor corneas in severe infective keratitis. METHODS: Glycerol-preserved corneas were obtained from the recipient corneas of the patients who underwent optical penetrating keratoplasty and preserved in glycerol. Eight eyes of 8 patients (3 men/5 women; average age, 69.7 years) with severe corneal ulcer with perforation were treated with TPKP using glycerol-preserved corneas. RESULTS: With a mean follow-up time of 31.1 months (range, 9-58 months), satisfactory anatomical integrity was obtained in 7 patients (87.5%) at the end of the follow-up. Eradication of infection without recurrence was obtained in 7 eyes (87.5%). The mean reepithelialization time was 10.2 days. One patient (12.5%) received secondary optical penetrating keratoplasty. The pre-TPKP visual acuity ranged from no light perception to 0.06. After surgery, 4 eyes (50%) improved or maintained preoperative visual acuity and four eyes (50%) had no light perception but maintained anatomical integrity. One had a recurrent infection and needed antibiotics and amniotic membrane graft. One suffered from secondary glaucoma and received evisceration 19 months later. CONCLUSIONS: Glycerol-preserved donor corneas may be effective substitutes in TPKP to control severe infective keratitis and preserve anatomical integrity.