OUTCOME OF THERAPEUTIC PENETRATING KERATOPLASTY IN A TERTIARY EYE HOSPITAL IN NEPAL

Abstract

Background: Therapeutic penetrating keratoplasty is the most common variety of keratoplasty performed in the developing countries. The objective of this study was to assess the outcome of therapeutic penetrating keratoplasty in infective keratitis.

Methods: This was a hospital based retrospective study where medical records of patients who underwent therapeutic penetrating keratoplasty between July 2021 and December 2022 were analyzed. Data collected included demographic parameters, indications for surgery, microbiology of the ulcers, donor details. Success was evaluated in terms of eradication of the disease, anatomical stability, graft clarity and visual acuity. SPSS software version 20.0 was used for statistical analysis. The mean, standard deviation, frequency and percentage were calculated

Results: Sixty-seven patients of therapeutic penetrating keratoplasty who completed 2 months of follow-up after surgery were included in the study. Corneal scrapings and corneal buttons were positive for organisms in 19 cases (90.47%) and 20 cases (29.85%) respectively. In all,out of 67 eyes, 30 (44.77%) were positive for organisms in smear or culture or both, of which 27 cases showed pure fungus and 3 cases showed pure bacteria. Aspergillus (8, 29.62%) was the commonest fungus isolated. Eradication of infection after the primary procedure was seen in 48 cases (71.64%). Anatomical success was seen in 60 eyes (89.50%), clear grafts were seen in 23 eyes (34.32%). Visual acuity of ≥6/60 was seen in 14 eyes (20.89%).

Conclusions: Therapeutic penetrating keratoplasty provided good success in terms of maintaining anatomical integrity and helps in eradication of infection while giving satisfactory functional outcome.