title: Outcomes of Infectious versus Sterile Perforated Corneal Ulcers after Therapeutic Penetrating Keratoplasty in the United States.
abstract: Purpose. To compare the long-term outcomes of infectious versus sterile perforated corneal ulcers after therapeutic penetrating keratoplasty in the United States.Methods. The charts of 45 consecutive eyes that underwent primary therapeutic penetrating keratoplasty for a perforated corneal ulcer at a single center were retrospectively reviewed. The perforated ulcers were classified as infectious or sterile and the underlying demographics, clinical features, and 36-month outcomes were compared among the two groups.Results.Mean follow-up among subjects was 38.6 (±6.9) months. Patients presenting with sterile perforated ulcers were more likely to have a peripheral perforation location (p= 0.0333) and recurrence of the underlying disease condition (p= 0.0321), require adjunctive surgical measures in the immediate postoperative period (p< 0.0001), have reperforation after keratoplasty (p= 0.0079), have worse best corrected visual acuity (p= 0.0130), develop no light perception vision (p= 0.0053), and require enucleation/evisceration (p= 0.0252) when compared to the infectious perforated ulcer group.Conclusions. Sterile perforated corneal ulcers have a worse prognosis and may be more frequent than those caused by infectious disease in the United States compared to the developing world.
authors.affiliation: Panhandle Eye Group, 7400 Fleming Ave., Amarillo, TX 79106, USA; Texas Tech University Health Sciences Center, 1400 S. Coulter, Amarillo, TX 79106, USA.
authors.forename: Sloan W
authors.initials: SW
authors.lastname: Rush
authors.affiliation: Panhandle Eye Group, 7400 Fleming Ave., Amarillo, TX 79106, USA; Texas Tech University Health Sciences Center, 1400 S. Coulter, Amarillo, TX 79106, USA; Southwest Retina Specialists, 7411 Wallace Blvd., Amarillo, TX 79106, USA.
authors.forename: Ryan B
authors.identifier: 0000-0003-2790-6155
authors.initials: RB
authors.lastname: Rush