Therapeutic penetrating keratoplasty: indications and results in Tunisia

To report the experience of the Tunis Institute of Ophthalmology (Tunisia) in therapeutic penetrating keratoplasty. We retrospectively analyzed 35 patients after therapeutic penetrating keratoplasty over a period of 6 years (between September 2002 and September 2008). The mean patient age was 49.3 years. Men outnumbered women by a ratio of 2.5 to 1. The mean follow-up was 13.5 months. Corneal diseases within a therapeutic penetrating keratoplasty were divided into infectious keratitis (21 eyes) and noninfectious diseases (14 eyes). Herpetic keratitis was the most common etiology (11 eyes). The anatomical success rate was 92.4%, with infection eradicated in 80% of cases. The graft clarity at the end of follow-up was 54.2%. Rejection was the leading cause of graft opacification (50%). Final visual acuity was better than 1/10 in 25.7% of patients. Recovery of useful vision was observed in 45.7% of patients. Therapeutic penetrating keratoplasty is a surgical technique that has proved its effectiveness in maintaining the integrity of the eyeball. The prognosis for this intervention would probably be better if it could be postponed.