PK effective for fungal keratitis corneal perforations despite possible complications, study finds

Penetrating keratoplasty appears effective for treating corneal perforations caused by fungal keratitis, although complications are likely, according to a study by researchers in China.

Lixin Xie, MD, of Shandong Eye Institute and Hospital in Qingdao, and colleagues reviewed outcomes for 52 eyes of 52 patients. At final follow-up, the researchers found that 44 grafts (84.6%) remained clear, and 46 eyes (88.5%) had improved visual acuity, according to the study.

However, investigators found that 20 eyes (38.5%) experienced graft rejection after the primary surgery. Of these, 12 eyes were managed medically. The remaining eight eyes underwent a secondary surgery, and four acquired clear grafts, according to the study authors.

Fungal infection recurred in eight eyes (15.4%), of which three were controlled with antifungal medications, three were treated with a secondary penetrating keratoplasty and two were enucleated.

Ten eyes (19.2%) had complicated cataracts and underwent intra- or postoperative extracapsular cataract extraction. Graft ulcers occurred in five eyes (9.6%), of which two resolved with medical therapy and three resolved after amniotic membrane transplantation.

The study is published in the February issue of Cornea.