Outcomes of Therapeutic Penetrating Keratoplasty in a Tertiary Care Hospital in Thailand
Keywords:
Therapeutic penetrating keratoplasty, corneal ulcer, corneal perforation, anatomical success, therapeutic success, functional successAbstract
Objective To study the outcomes of Therapeutic Penetrating Keratoplasty (TPK) in a tertiary hospital in
Thailand
Method A retrospective study was performed by reviewing hospital records of patients underwent TPK
in Mettapracharak (Wat Raiking) Hospital during January 2016 and December 2018. Demographic data,
preoperative, operative and post-operative ophthalmic data were collected. Post-operative follow up were
performed in month 1, 3 and 6. The study was performed to analyze the outcomes of TPK and determine
the factors that affected the therapeutic outcome.
Results During the study period, there were 277 keratoplasties in the hospital. TPK accounted for 81 eyes
(29.2%). Ninety percent of the patients were referred from other hospitals. Sixty five percent of the patients
have fungal corneal infections. The anatomical success, therapeutic success and functional success were
achieved in 79.0%, 88.8% and 74.0% respectively. Analysis of risk factors associated with treatment failure
shows that corneal perforation was associated with anatomical failure (OR = 23.26, p < 0.0001), functional
failure (OR = 5.95, p = 0.002) but no effect on therapeutic success (OR = 1.0, p = 0.49.).
Conclusion TPK is the last treatment measure to try to preserve the patient’s’ eye in patients with severe
corneal infections or corneal perforation. In this series, 79% of globe could be salvaged, 88% of eyes could
get rid of infection and 74% of eyes could maintain vision. The earlier TPK decision should result in better
treatment results.
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The Thai Journal of Ophthalmology (TJO) is a peer-reviewed, scientific journal published biannually for the Royal College of Ophthalmologists of Thailand. The objectives of the journal is to provide up to date scientific knowledge in the field of ophthalmology, provide ophthalmologists with continuing education, promote cooperation, and sharing of opinion among readers.
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