[Long-term follow-up of a case series of therapeutic corneal transplant].

PURPOSE To describe the results of therapeutic penetrating keratoplasty in patients with impending perforation or perforated infectious keratitis. METHODS Fifty-nine charts of patients with infectious keratitis who were submitted to therapeutic penetrating keratoplasty were retrospectively reviewed at the Department of Ophthalmology of the Santa Casa of São Paulo from January 2000 to December 2004. Pre- and post operative visual acuity, biomicroscopy, echography, culture and bacterioscopy were analyzed. Patients with a minimum 9-month follow-up were included and were divided into 5 groups: herpetic, bacterial, fungal, bacterial-fungal keratitis and keratitis with negative culture bacterioscopy. RESULTS Eradication of infection and restoration of ocular integrity were obtained in 95.2% of all bacterial keratitis; 100% fungal; 25.0% bacterial-fungal; 95.2% negative culture and 100% of all herpetic keratitis. Complications included: 2 rejections, 6 recurrences, 13 glaucomas and 1 perforation. CONCLUSION In infectious keratitis with perforation or impending perforation that did not respond to conservative clinical therapy, therapeutic penetrating keratoplasty must be considered an alternative to eradicate infection and restore the ocular integrity.