Therapeutic penetrating keratoplasty for recalcitrant microbial keratitis: An update

Table 2 Pooled outcomes of therapeutic keratoplasty in severe keratitis

Outcome measure	Pooled result (95%CI)	Interpretation
Anatomical success (globe intact)	89% (88%-91%)	Eye preserved without requiring evisceration or enucleation in 9 out of 10 cases
Therapeutic success (infection cured)	91% (89%-92%)	Infection eradicated post-TPK in majority of eyes
		Recurrence of primary infection occurs in 9% overall (higher if fungal)
Clear graft at final follow-up	45% (43%-48%)	Proportion of grafts remaining clear (no significant opacity or failure) at last follow-up
		Many grafts turn opaque or fail over time despite initial success
Functional visual recovery	20% (range 15%-25% across studies)	Eyes achieving ambulatory vision (≥ 6/60) after TPK were a minority
		Poor initial ocular condition and graft complications limit visual acuity in most cases

Pooled estimates (random-effects) are derived from the 10 included studies using weighted averages based on sample size (95% confidence intervals in parentheses). “Functional vision” generally corresponds to ambulatory vision (approx ≥ 6/60 or ≥ 20/200 Snellen) at final follow-up; because definitions varied, a range is given instead of a pooled value. Statistical analyses were performed using IBM SPSS Statistics (Version 26). Heterogeneity across studies was assessed using I² statistics where applicable. TPK: Therapeutic penetrating keratoplasty; CI: Confidence interval.