Clinical ScienceOutcome of Therapeutic Keratoplasty in Hopeless Microbial Keratitis Cases Otherwise Advised EviscerationJain, Rajat MS*; Bhutia, Karma L. MS†; Mohan, Neha MS*; Gupta, Col K. C. MS‡; Ghai, Ashwani MS§Author Information *Department of Ophthalmology, drishtiCONE Eye Care, Shalimar Bagh, Delhi; †Department of Ophthalmology, Sikkim Manipal Institute of Ophthalmology, Rangpo, Sikkim; ‡Department of Ophthalmology, Action Balaji Hospital Delhi, Paschim Vihar, Delhi; and §Department of Ophthalmology, Sri Guru Gobind Singh Tricentenary University, Gurgaon, Haryana. Reprints: Rajat Jain, MS, Cornea and Anterior Segment Services, drishtiCONE Eye Care, Shalimar Bagh, Delhi 110088 (e-mail: [email protected]). The authors have no funding or conflicts of interest to disclose. Cornea: February 2018 - Volume 37 - Issue 2 - p 151-155 doi: 10.1097/ICO.0000000000001432 Buy Metrics Abstract Purpose: To study the outcome of therapeutic keratoplasty in severe microbial keratitis cases otherwise advised evisceration. Methods: A retrospective, single-center clinical audit included 28 patients with severe microbial keratitis presenting from April 2014 to April 2016. Patients with microbial keratitis either affecting more than 2 quadrants of the limbus and/or cases with infections involving more than 180 mm2 of the cornea who were advised evisceration by more than one ophthalmologist were included. Cases with endophthalmitis were excluded. At 3 months, the outcome was “success” if resolution of infection occurred without recurrence and evisceration was not required. Success was termed “complete” if best vision was 6/24 or better and “partial” otherwise. The outcome was termed a “failure” if infection recurred in the graft or the eye was eviscerated. Results: Mean age of the patients (male:female, 17:11) was 49.5 years, and the mean duration of symptoms before surgery was 28.6 days. Evisceration was required in 2/28 cases. The outcome was “success” in 22/28 cases (78.6%)—complete (10/22); partial (12/22)—and “failure” in 6/28 cases. The outcome was poorer in general in fungal keratitis (n = 16) than bacterial keratitis (n = 7). Conclusions: Primary evisceration is best avoided in infections limited to the anterior segment. Even in hopeless cases, every eye deserves a fair chance. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.