Outcome of Therapeutic Penetrating Keratoplasty in R.M. Kedia Eye hospital - A Retrospective Study

Leesha Shrestha Joshi, C. Shrestha, Bibhuti Thapa, Reeta Rajbhandari
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Abstract

Infectious keratitis is the major cause of vision threatening condition and the leading cause of corneal blindness in developing countries. Therapeutic keratoplasty is the procedure for terminating or improving an actively infectious corneal disease. This study was carried out to determine the outcome of therapeutic keratoplasty for infective keratitis at R.M. Kedia eye hospital. This was retrospective study where all cases that underwent TPK for active infective keratitis from May 2019 to April 2020 were included in the study. Data were collected about demographic parameters, indication for surgery, details of donor tissue in terms of donor size, graft size and endothelial density. The outcome of TPK was measured in terms of anatomic stability, eradication of disease, graft clarity and development of cataract and glaucoma. 30 eyes of 30 patients underwent TPK for infective keratitis. 73.3% were male. Average age of the patients was 42. In 60% of patients organisms were isolated as follows: 11 cases of fungus, 3 cases of bacteria and 4 cases of mixed bacteria and fungus. Two surgeries (6.6%) were combined with extracapsular cataract extraction without posterior chamber intraocular lens. The eradication of infection after primary TPK was 23 (76.8%). Twelve eyes (40%) had documentation of variable grades of cataract. One case had secondary glaucoma. Six cases (20%) had graft failure. Therapeutic keratoplasty is the procedure for terminating or improving an actively infectious corneal disease. It helps to save the eye and preserve vision in severe infective keratitis. There is a high incidence of postoperative glaucoma, cataract, and graft failure in such a surgery.
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R.M. Kedia眼科医院穿透性角膜移植术疗效的回顾性研究
在发展中国家,感染性角膜炎是造成视力威胁的主要原因,也是导致角膜失明的主要原因。治疗性角膜移植术是一种终止或改善传染性角膜疾病的手术。本研究是在R.M.Kedia眼科医院进行的,目的是确定感染性角膜炎的治疗性角膜移植术的结果。这是一项回顾性研究,将2019年5月至2020年4月因活动性感染性角膜炎接受TPK的所有病例纳入研究。收集了有关人口统计学参数、手术指征、供体组织在供体大小、移植物大小和内皮密度方面的细节的数据。根据解剖稳定性、疾病根除、移植物清晰度以及白内障和青光眼的发展来测量TPK的结果。30例患者中30眼因感染性角膜炎行TPK治疗。男性占73.3%。患者的平均年龄为42岁。在60%的患者中,分离出的生物体如下:真菌11例,细菌3例,细菌和真菌混合4例。两个手术(6.6%)联合白内障囊外摘除术,无后房型人工晶状体。原发性TPK后感染的根除率为23(76.8%)。12眼(40%)有不同级别白内障的记录。1例为继发性青光眼。6例(20%)移植失败。治疗性角膜移植术是一种终止或改善传染性角膜疾病的手术。在严重的感染性角膜炎中,它有助于保护眼睛和视力。在这种手术中,术后青光眼、白内障和移植物衰竭的发生率很高。
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