Efficacy observation of porcine corneal acellular stromal deep lamellar keratoplasty in the treatment of infectious keratitis

AIM: To evaluate the efficacy and safety of porcine corneal acellular stromal deep lamellar keratoplasty in the treatment of infectious keratitis.METHODS:Prospective study. A total of 17 patients(17 eyes)with infectious keratitis who failed to receive conservative treatment in our hospital from February 2017 to October 2020 were collected, and porcine corneal acellular stromal deep lamellar keratoplasty was performed using acellular porcine corneal matrix. The postoperative follow-up was 6 mo, and best corrected visual acuity(BCVA), corneal epithelial healing, corneal transparency were observed, and the recurrence of infection and graft rejection were recorded.RESULTS:All patients successfully underwent deep lamellar keratoplasty without intraoperative complications, and there were no cases of loss to follow-up. Postoperative corneal infections were effectively controlled, and BCVA was improved(P<0.05). The complete epithelial coverage of the graft was achieved in 16 eyes by 1 mo postoperatively. Only 1 eye did not achieve complete epithelialization within this period, accompanied by relapse of viral keratitis. However, by 1.5 mo postoperatively, all patients had fully healed epithelium. Corneal edema began to improve 1 month after surgery, with 1 eye with mild turbidity and 16 eyes with severe turbidity. Corneal transparency was stable 3-6 mo after surgery, and 4 eyes were completely transparent, 6 eyes were mildly turbid, 6 eyes were moderately turbid, and 1 eye was severely turbid at 6 mo. During the follow-up period, there were no recurrences of infection, while 1 eye experienced elevated intraocular pressure, which was successfully managed with treatment.CONCLUSION: The acellular porcine corneal stroma deep lamellar keratoplasty for the treatment of infectious keratitis not only effectively controls infection and alleviates corneal irritation symptoms, but also restores corneal anatomy and function. Additionally, it maintains good transparency and improves patients' vision, making it a viable alternative to allogeneic human corneas.