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Journal of Ophthalmology
Volume 2016, Article ID 6284595, 6 pages
Clinical Study

Outcomes of Infectious versus Sterile Perforated Corneal Ulcers after Therapeutic Penetrating Keratoplasty in the United States

1Panhandle Eye Group, 7400 Fleming Ave., Amarillo, TX 79106, USA
2Texas Tech University Health Sciences Center, 1400 S. Coulter, Amarillo, TX 79106, USA
3Southwest Retina Specialists, 7411 Wallace Blvd., Amarillo, TX 79106, USA

Received 28 October 2016; Accepted 22 November 2016

Academic Editor: Flavio Mantelli

Copyright © 2016 Sloan W. Rush and Ryan B. Rush. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To compare the long-term outcomes of infectious versus sterile perforated corneal ulcers after therapeutic penetrating keratoplasty in the United States. Methods. The charts of 45 consecutive eyes that underwent primary therapeutic penetrating keratoplasty for a perforated corneal ulcer at a single center were retrospectively reviewed. The perforated ulcers were classified as infectious or sterile and the underlying demographics, clinical features, and 36-month outcomes were compared among the two groups. Results. Mean follow-up among subjects was 38.6 (±6.9) months. Patients presenting with sterile perforated ulcers were more likely to have a peripheral perforation location () and recurrence of the underlying disease condition (), require adjunctive surgical measures in the immediate postoperative period (), have reperforation after keratoplasty (), have worse best corrected visual acuity (), develop no light perception vision (), and require enucleation/evisceration () when compared to the infectious perforated ulcer group. Conclusions. Sterile perforated corneal ulcers have a worse prognosis and may be more frequent than those caused by infectious disease in the United States compared to the developing world.