Edwar L, Budiman D, Sitompul R, Susiyanti M, Nora RLD, Aziza Y, Tuasikal RM, Badruddin GH. Clinical characteristics and outcomes of keratoplasty in moderate to severe infective corneal ulcers. World J Transplant 2025; 15(4): 106380 [DOI: 10.5500/wjt.v15.i4.106380]
Corresponding Author of This Article
Lukman Edwar, MD, Associate Professor, Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No. 71, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta, Jakarta 10430, Indonesia. lukmanedwar@gmail.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 18, 2025 (publication date) through Nov 19, 2025
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Transplantation
ISSN
2220-3230
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Edwar L, Budiman D, Sitompul R, Susiyanti M, Nora RLD, Aziza Y, Tuasikal RM, Badruddin GH. Clinical characteristics and outcomes of keratoplasty in moderate to severe infective corneal ulcers. World J Transplant 2025; 15(4): 106380 [DOI: 10.5500/wjt.v15.i4.106380]
World J Transplant. Dec 18, 2025; 15(4): 106380 Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.106380
Clinical characteristics and outcomes of keratoplasty in moderate to severe infective corneal ulcers
Lukman Edwar, Dicky Budiman, Ratna Sitompul, Made Susiyanti, Rina La Distia Nora, Yulia Aziza, Ramadhiana Maktazula Tuasikal, Gabriella Hafidha Badruddin
Lukman Edwar, Dicky Budiman, Ratna Sitompul, Made Susiyanti, Rina La Distia Nora, Yulia Aziza, Ramadhiana Maktazula Tuasikal, Gabriella Hafidha Badruddin, Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Author contributions: Edwar L participated in the conception and design of the study, acquisition, analysis, and interpretation of the data, and served as the first and corresponding author; Budiman D and Sitompul R contributed to the study design, and data analysis and interpretation; Susiyanti M, Nora RL, and Aziza Y were involved in the data acquisition, collection and interpretation; Tuasikal RM and Badruddin GH participated in the verification and manuscript preparation; All authors critically reviewed and approved the final version of the manuscript and were responsible for the decision to submit the manuscript for publication.
Institutional review board statement: The Ethics Committee of the Faculty of Medicine, University of Indonesia had carefully reviewed (Ethical number: 1302/UN2.F1/ETIK/PPM.00.02/2020) and approved our research protocol on November 2, 2020.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lukman Edwar, MD, Associate Professor, Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No. 71, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta, Jakarta 10430, Indonesia. lukmanedwar@gmail.com
Received: February 25, 2025 Revised: March 29, 2025 Accepted: April 24, 2025 Published online: December 18, 2025 Processing time: 268 Days and 2.3 Hours
Abstract
BACKGROUND
Corneal ulcers are a major cause of visual impairment in developing countries. In Indonesia, severe infective ulcers often require keratoplasty (KP) to preserve ocular integrity and improve outcomes.
AIM
To determine demographic, clinical and microbiological characteristics, complications, and KP outcomes in patients with moderate to severe infective corneal ulcers.
METHODS
A retrospective review was conducted on patients with moderate to severe infective corneal ulcers who underwent KP between January 1, 2018 and December 31, 2020, with a minimum follow-up period of 3 weeks at the Ocular Infection and Immunology clinic of a tertiary referral hospital in Jakarta. Data were extracted from medical records.
RESULTS
A total of 99 eyes from 99 patients with a mean age of 41.7 ± 16.2 years were included. Eight-nine eyes of corneal cases were located at the central cornea with > 6 mm lesion size (forty-one eyes). The culture positivity rate was 33%, primarily composed of Staphylococcus epidermidis. Eyeball integrity was maintained in all patients. Mean uncorrected visual acuity (VA) before KP was 2.50 and improved to 2.04 after 3 months of follow-up. Twenty patients with a cornea that was kept transparent achieved a VA of 0.40. Complications after KP appeared in 60 eyes, while secondary glaucoma was the most common complication (28 eyes), followed by graft failure (24 eyes) and graft rejection (14 eyes).
CONCLUSION
Corneal ulcers are a common problem in Indonesia following eye trauma. Therapeutic and tectonic KP can preserve the integrity of the eyeball in moderate to severe cases, although complications are common.
Core Tip: Corneal ulcers represent a significant cause of visual impairment in Indonesia, commonly following ocular trauma. This study highlights that therapeutic and tectonic keratoplasty effectively preserves eyeball integrity in moderate to severe infective corneal ulcers. Despite a notable improvement in visual acuity, complications such as secondary glaucoma and graft failure are prevalent, emphasizing the need for vigilant post-operative management.
