Clinical Observation of Therapeutic Keratoplasties for Infectious Keratitis: A Retrospective Cohort Study

Abstract

\n Background: To investigate the therapeutic outcomes of two types of keratoplasties in patients with infectious keratitis.Methods: This retrospective cohort study enrolled 52 consecutive patients (52 eyes) with medically uncontrolled infectious keratitis who underwent deep lamellar keratoplasty (DLKP) (n=16 eyes) or penetrating keratoplasty (PKP) (n=36 eyes; 24 nonperforated ulcers; 12 perforated ulcers) with a follow-up of 12 to 36 months (mean follow-up duration: DLKP, 24.6 months; PKP: 25.7 months) between June 2014 and 2019 at the Department of Ophthalmology, The Third Hospital of Hebei Medical University. The clinical characteristics, preoperative, and postoperative best-corrected visual acuity (BCVA) outcomes, therapeutic success rate, graft rejection, management, and complications were assessed.Results: The postoperative BCVA increased by 93.8% (15/16 eyes) and 77.2% (27/36 eyes) at the one-year follow-up in the DLKP and PKP groups, respectively: the differences were not statistically significant (p=0.149). The therapeutic success rates did not differ (statistically) significantly between the DLKP (81.2%) and PKP (80.6%) groups (p=0.953). The incidence of secondary glaucoma was 6.25% and 33.33% in the DLKP and PKP groups, respectively, and the difference between them was statistically significant (p=0.037). The graft survival rates at the one-year follow-up differed significantly between the DLKP (12.5%) and PKP (42.9%) groups (p=0.033).Conclusion: Infectious keratitis is common in male farmers in northern China. Therapeutic keratoplasty is the most commonly performed vision-saving procedure for patients with severe serious infectious keratitis, which can improve the quality of life significantly. Bandage contact lenses were commonly used to protect the cornea and ameliorate pain. DLKP and PKP elicited good clinical outcomes with respect to visual recovery and therapeutic success. The frequencies of graft rejection and complications were lower with DLKP compared to PKP. Surgery should be considered at the early stage in patients with refractory infectious keratitis to improve the therapeutic success.