title: Penetrating keratoplasty for perforated corneal ulcers under topical anesthesia.
abstract: OBJECTIVE
  To evaluate the structural and functional outcomes of eyes with perforated corneal ulcers undergoing penetrating keratoplasty (PKP) under topical anesthesia.
  
  
  METHODS
  A prospective analysis of 17 consecutive cases that underwent PKP under topical anesthesia, where infiltrative anesthesia was contraindicated or general anesthesia could not be given for medical reasons or was not available for logistical reasons.
  
  
  RESULTS
  Seventeen eyes of 15 patients with a mean age of 47.3 ± 16.2 years underwent a PKP for treating perforated corneal ulcers under topical anesthesia. Perforation involved the pupillary zone in 13 (76.5%) cases. Preoperatively, 8 patients (47.1%) were phakic, 8 (47.1%) were pseudophakic, and 1 (5.9%) was aphakic. The PKP was completed successfully in all the eyes. An anterior capsular tear occurred in 3 eyes (17.6%). A posterior chamber intraocular implant was put in 1 eye, and 2 eyes were found to be aphakic. The patients reported mild to moderate discomfort and tolerated the procedure well. At the final follow-up, 10 patients had clear grafts (58.8%), and 7 patients (41.2%) had partially clear grafts. The best-corrected visual acuity was better than 6/18 in 10 eyes and between 6/60 and 6/24 in 7 eyes.
  
  
  CONCLUSIONS
  PKP can be performed successfully under topical anesthesia in cooperative patients who have perforated corneal ulcers.
authors.affiliation: Department of Ophthmology, *Baba Deep Singh Charitable Hospital, Amritsar, Punjab, India; †Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; and ‡Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
authors.forename: Rashim
authors.initials: R
authors.lastname: Mannan
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.forename: Archna
authors.initials: A
authors.lastname: Pruthi
authors.forename: Prafulla K
authors.initials: PK
authors.lastname: Maharana
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003320:Corneal Ulcer / Q000601:surgery*; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local