title: Therapeutic keratoplasty for corneal perforation: clinical results and complications.
abstract: OBJECTIVE
  To report the clinical results, postoperative progress, and complications after therapeutic keratoplasty for corneal perforation.
  
  
  METHODS
  Twenty consecutive eyes (20 patients) that underwent therapeutic keratoplasty between December 2003 and May 2006 were included. The eyes were evaluated retrospectively for the cause of the corneal perforation, the type of surgical technique and intraoperative complications, anatomic cure rates, graft clarity, visual prognosis, and postoperative complications.
  
  
  RESULTS
  The causes of corneal perforation were herpetic keratitis (n = 5), bacterial ulcer (n = 1), fungal ulcer (n = 1), neurotrophic ulcer (n = 3), rheumatoid arthritis (n = 2), Mooren ulcer (n = 2), Terrien marginal corneal degeneration (n = 1), keratoconus (n = 1), and Wegener granulomatosis (n = 1). In 3 cases, the etiology was unknown. Six cases had a previous history of corneal transplantation. Anatomic cures were obtained in 16 (80%) of 20 eyes after the first transplantation procedure. Visual acuity (VA) equal to or better than the preoperative level was achieved in 17 (85%) of 20 eyes. The graft transparency rate was 67% in 15 eyes that underwent central penetrating keratoplasty with fresh donor tissue. Major postoperative complications included cataract (n = 6), glaucoma (n = 4), and recurrent disease (n = 3).
  
  
  CONCLUSIONS
  Keratoplasty is valuable for maintaining the ocular integrity and VA. In cases with severe preoperative inflammation of the anterior segment, it is difficult to achieve transparency after the first graft.
authors.affiliation: Department of Ophthalmology, Asahikawa Medical College, Asahikawa, Japan. hanada@asahikawa-med.ac.jp
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Hanada
authors.forename: Sho
authors.initials: S
authors.lastname: Igarashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Muramatsu
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D003316:Corneal Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D015948:Keratoplasty, Penetrating; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology