Prognosis of keratoplasty in viral keratitis.

We reviewed 45 eyes with active or inactive herpetic keratitis that underwent penetrating keratoplasty. In Group I, 15 eyes underwent penetrating keratoplasty without prior optical iridectomy. In Group II, 15 eyes underwent penetrating keratoplasty after prior optical iridectomy. In Group III, 15 eyes underwent penetrating keratoplasty with pupilloplasty after prior optical iridectomy. Graft clarity of 3+ or more was obtained after one year in 67%, 33%, and 60% of eyes in Groups I, II, and III, respectively. Visual outcome of 6/24 or better was found in 53% of all eyes during the one-year follow-up. The occurrence of cataract both pre- and postoperatively could have been a result of prolonged use of corticosteroids and/or uveitis. Although there were several variables apart from preoperative vascularization and cataract, prior optical iridectomy was identified as a risk factor with regard to post-operative complications, final visual acuity, and graft clarity.