Extensive corneal disease secondary to microbial keratitis can result
in frank or impending corneal perforation requiring a large penetratin
g keratoplasty. In an 8-year period, 26 penetrating keratoplasties wit
h recipient beds of greater than or equal to 9.5 mm were performed on
22 eyes: 11 for bacterial keratitis, 10 for fungal keratitis, and one
for a mixed bacterial and fungal keratitis, The graft failed in 18 of
19 eyes (94.7%), with a median time to failure of 12.9 weeks in bacter
ial keratitis and 4.0 weeks in fungal keratitis. After large keratopla
sty, 17 of 20 eyes (85.0%) maintained the structural integrity of the
globe. The remainder became phthisical or required enucleation, With p
reservation of the structural integrity of the globe, a subsequent sma
ller optical penetrating keratoplasty is an option in some of these ey
es.