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Therapeutic Keratoplasty for Corneal Perforation: Clinical Results and Complications

Hanada, Kazuomi MD*; Igarashi, Sho MD; Muramatsu, Osamu MD*; Yoshida, Akitoshi MD*†

doi: 10.1097/ICO.0b013e31815b82f2
Clinical Science

Purpose: 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.

From the *Department of Ophthalmology and the †Department of Ocular Tissue Engineering, Asahikawa Medical College, Asahikawa, Japan.

Received for publication May 15, 2007; revision received September 7, 2007; accepted September 16, 2007.

The authors state that they do not have any proprietary interest in the products named in this article.

Reprints: Kazuomi Hanada, Department of Ophthalmology, Asahikawa Medical College, 2-1-1 Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan (e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.