Corneal and external disorders: Edited by Kristin HammersmithTherapeutic keratoplasty for microbial keratitisSharma, Namrataa; Sachdev, Ritikaa; Jhanji, Vishala,b; Titiyal, Jeewan Sa; Vajpayee, Rasik Ba,b Author Information aR P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Australia bCentre for Eye Research, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia Correspondence to Namrata Sharma, MD, R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi-110029, India Fax: +91 011 26588919; e-mail: [email protected]; [email protected] Current Opinion in Ophthalmology: July 2010 - Volume 21 - Issue 4 - p 293-300 doi: 10.1097/ICU.0b013e32833a8e23 Buy Metrics Abstract Purpose of review The purpose of this review is to provide an update of peer-reviewed literature published over the previous 2 years on various aspects of therapeutic keratoplasty. Recent findings Therapeutic keratoplasty has a definitive role in the management of progressive microbial keratitis refractory to medical therapy. The primary aim of the procedure is to eliminate the infectious disease process and establish the integrity of the globe. This procedure offers a microbiological cure rate of up to 100% in bacterial keratitis; recurrence of infection remains a concern following fungal infections and Acanthamoeba keratitis. Newer techniques like corneal debulking allow maximal preservation of the iris tissue in cases of perforated corneal ulcers. Lamellar procedures are emerging as promising alternatives to the full thickness graft in cases of infectious keratitis sparing the Descemet's membrane. In addition to adept intraoperative skills, intensive postoperative treatment and meticulous follow-up are pivotal to ensure success of a therapeutic graft. Summary Therapeutic keratoplasty is a challenging procedure and is associated with a poor prognosis for graft survival as compared with the optical grafts. The recent advances in lamellar keratoplasty and antimicrobial therapy contribute to the success in terms of microbiological cure and improved visual outcomes. © 2010 Lippincott Williams & Wilkins, Inc.