Result of therapeutic penetrating keratoplasty (PK) in cases of infectious keratitis from a tertiary hospital in gangetic West Bengal

Background: To assess the outcome of therapeutic penetrating keratoplasty(PK) in nonresponsive microbial keratitis cases. Material and methods: Clinical outcomes of sixty patients who underwent therapeutic PK by a single surgeon in our Institute between April 2004 and March 2008 were retrospectively analysed from data obtained from Institutional PK registry of medical record section. Outcome parameters considered were restoration of structural integrity of eye ball, eradication of infection, prevention of complication and visual outcome. Infection was considered eradicated if there was no evidence of corneal infiltration and in anterior chamber for 1 month post surgery. Anatomical success was considered if the integrity of the eye was restored in perforated or non-perforated corneas for at least 1 month after surgery. Result: In early postoperative period, anatomical integrity was achieved in all cases(100%).Twelve patients(20%) developed recurrence of infection in graft and subsequently needed a second graft. More than 50% cases had pre-operative vision ranging from hand movement to perception of light.4 cases had VA in the range of 6/60-6/36.Post-operative VA ranged from PL(53.3%) to 6/60(10%). Only one case had 6/12 or better vision. Conclusion: Therapeutic PK is a viable treatment option in cases of recalcitrant microbial keratitis.