Deep anterior lamellar keratoplasty with cross‐linked acellular porcine corneal stroma to manage fungal keratitis

Purpose To evaluate the effects of deep anterior lamellar keratoplasty (DALK) with cross‐linked acellular porcine corneal stroma (APCS) and post‐operative topical tacrolimus treatment in patients with fungal keratitis. Methods This multicenter prospective study involved 25 cases of fungal keratitis that were treated by DALK with cross‐linked APCSs and post‐operative topical tacrolimus from December 2013 to November 2014 at the Wenzhou Eye Hospital and the Henan provincial Eye Hospital. Signs of post‐operative inflammation, corneal reepithelialization, corneal neovascularization, and graft rejection were assessed, and best corrected visual acuity (BCVA), intraocular pressure (IOP), and APCS graft transparency were monitored for the 12‐month follow‐up period. Results All 25 patients underwent DALK without Descemet's membrane perforation. Corneal epithelium recovered completely in 17 patients in the first week, and APCS grafts maintained transparency in 18 patients at 1‐year follow‐up. The mean BCVA significantly improved from 2.16 ± 0.32 (LogMAR) at baseline to 1.56 ± 0.70 at 1‐week (P