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Updated: Jul 17, 2026
Corneal Donor Tissue Preparation for Endothelial Keratoplasty
Published on: June 12, 2012
Penetrating keratoplasty for corneal perforations in fungal keratitis
Lixin Xie1, Hualei Zhai, Weiyun Shi
1State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Qingdao, China. lixinxie@public.qd.sd.cn
Purpose:
To evaluate the complications and therapeutic effects of penetrating keratoplasty (PKP) in the treatment of corneal perforations in fungal keratitis.
Methods:
The medical records of patients who underwent PKP for corneal perforations in fungal keratitis at Shandong Eye Institute from January 1999 to December 2004 were retrospectively reviewed.
Results:
Fifty-two patients (52 eyes) were included in this study. Twenty eyes (38.5%) had graft rejection after primary PKP, 12 of which were medically treated, and 8 underwent secondary PKP with 4 acquiring clear grafts. Fungal infection recurred in 8 eyes (15.4%), 3 of which were controlled with antifungal agents, 3 were treated with secondary PKP, and 2 were enucleated. Ten eyes (19.2%) with complicated cataract underwent intraoperative or postoperative extracapsular cataract extraction. Seven eyes (13.5%) with secondary glaucoma were cured. Graft ulcer occurred in 5 eyes (9.6%), 3 of which were cured with amniotic membrane transplantation and 2 with medications. Forty-four grafts (84.6%) remained clear at final follow-up, and 46 eyes (88.5%) had improved visual acuity.
Conclusion:
Although many complications may occur, therapeutic PKP seems to be effective in the treatment of fungal keratitis with corneal perforation.
Insights
Penetrating keratoplasty (PKP) effectively treats fungal keratitis with corneal perforation, achieving clear grafts in 84.6% of cases. Despite potential complications like graft rejection and recurrence, visual acuity improved in most patients.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Infectious Diseases
Background:
- Fungal keratitis can lead to corneal perforation, a sight-threatening condition.
- Penetrating keratoplasty (PKP) is a surgical option for corneal perforation.
- Evaluating PKP outcomes in fungal keratitis is crucial for treatment strategies.
Purpose of the Study:
- To assess complications and therapeutic efficacy of PKP for fungal keratitis with corneal perforation.
- To analyze graft survival and visual outcomes post-PKP.
Main Methods:
- Retrospective review of medical records from 1999-2004.
- Inclusion of 52 patients (52 eyes) with fungal keratitis and corneal perforation undergoing PKP.
- Analysis of complications, graft status, and visual acuity.
Main Results:
- Graft rejection occurred in 38.5% of eyes; 50% of these achieved clear grafts after secondary PKP.
- Fungal infection recurrence was observed in 15.4% of eyes.
- At final follow-up, 84.6% of grafts remained clear, and 88.5% of eyes showed improved visual acuity.
Conclusions:
- Therapeutic PKP is an effective treatment for fungal keratitis with corneal perforation.
- Despite potential complications, PKP offers a favorable prognosis for visual recovery.
- Careful patient selection and management are key to successful outcomes.
