[Urgent penetrating keratoplasty in perforated infectious corneal ulcers].
OBJECTIVE
To evaluate anatomical and functional prognosis of urgent penetrating keratoplasty in perforated infectious corneal ulcers.


METHODS
Seven eyes of seven patients had an urgent penetrating keratoplasty for perforated infectious corneal ulcers. Anatomical success was defined by eradication of infection and preservation of eye from enucleation and phthisis bulbi. Corneal graft survival was defined by the presence of a clear graft.


RESULTS
The patients'mean age was 40.5 years. Four eyes had bacterial corneal ulcer and three eyes had herpetic corneal ulcer. Anatomical success was obtained in six eyes. The graft remained clear in two eyes. Graft rejection was noted in four eyes after a mean period of 4.5 months. Postoperative complications were ocular inflammation (one eye), ocular hypertension (three eyes), cataract (one eye), peripheral anterior synechiae (one1 eye), graft ectasia (one eye), bacterial infection (one eye) and recurrent herpetic keratitis (one eye). The mean follow-up period was 22 months, ranging from 9 to 32 months.


CONCLUSIONS
Urgent penetrating keratoplasty can preserve eye integrity and eradication of the infectious process in a large part of perforated bacterial and herpetic corneal ulcers. Visual rehabilitation is often a secondary objective. Adapted antimicrobial treatment reduces graft reinfection and steroid treatment reduces the frequency of some complications, especially graft rejection.
Boujemaa
C
C
Service d'Ophtalmologie A, Tunisie. Khaled_souissi@psy-tunisia.zzn.com
Souissi
K
K
Daghfous
F
F
Marrakchi
S
S
Jeddi
A
A
Ayed
S
S
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003320:Corneal Ulcer / Q000150:complications / Q000209:etiology / Q000601:surgery*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D016849:Keratitis, Herpetic / Q000150:complications*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D013997:Time Factors; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents