FP10

Clinical Outcomes of Large-Diameter Penetrating Keratoplasty in Proven Fungal Keratitis

Study Design: Prospective observational study.
Purpose: To evaluate outcomes of large-diameter penetrating keratoplasty (LDPK) with delayed steroid use in refractory fungal keratitis.
Methods: Twenty-nine patients with microbiologically confirmed resistant fungal keratitis underwent LDPK. Steroids were started after 15 days of antifungal therapy. Follow-up assessed graft clarity, rejection, reinfection, and complications.
Results: Mean age 30–70 years; 58.6% male. Trauma with vegetative matter (44.8%) and Fusarium (62.1%) predominated. Grafts 10–12 mm. Success without reinfection was 48.3%. Rejection 37.9%, reinfection and neovascularization 13.7% each, panophthalmitis 10.3%. Globe preservation 89.7%, clear grafts 65.5%.
Conclusion: LDPK supports globe preservation and vision; delayed steroids may improve outcomes despite risks.