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World J Transplant. Sep 18, 2026; 16(3): 120922
Published online Sep 18, 2026. doi: 10.5500/wjt.120922
Published online Sep 18, 2026. doi: 10.5500/wjt.120922
Therapeutic penetrating keratoplasty for recalcitrant microbial keratitis: An update
Ujjwal P Jha, Swati Kumari, Department of Ophthalmology - Cornea and Ocular Surface, Akhand Jyoti Eye Hospital, Saran 841219, Bihār, India
Md A Alam, Department of Ophthalmology - Cataract and Cornea, Akhand Jyoti Eye Hospital, Saran 841219, Bihār, India
Prateek Nishant, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna 800014, Bihār, India
Bharat Gurnani, Department of Cataract, Cornea and Ocular Surface, Gomabai Netralaya and Research Centre, Neemuch 458441, Madhya Pradesh, India
Kirandeep Kaur, Department of Cataract, Pediatric Ophthalmology and Strabismus, Gomabai Netralaya and Research Centre, Neemuch 458441, Madhya Pradesh, India
Ranjeet K Sinha, Department of Community Medicine, Patna Medical College, Patna 800004, Bihār, India
Sony Sinha, Department of Ophthalmology - Vitreoretina and Oculoplasty, All India Institute of Medical Sciences Patna, Patna 801507, Bihār, India
Author contributions: Jha UP, Alam MA, Nishant P, Kumari S, and Gurnani B screened the data and wrote the manuscript; Jha UP, Nishant P, Kaur K, Sinha RK, and Sinha S revised the manuscript; Nishant P and Sinha S conceptualized the manuscript; Jha UP, Alam MA, Nishant P, Kumari S, Gurnani B, Kaur K, Sinha RK, and Sinha S participated in analysis of the data; and all authors read and approved of the final version of the manuscript and agree to be accountable for all aspects of the work presented.
AI contribution statement: AI tools (specifically ChatGPT 3.5 and 4.0) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Sony Sinha, MS, Additional Professor, Department of Ophthalmology - Vitreoretina and Oculoplasty, All India Institute of Medical Sciences Patna, Patna-Aurangabad Highway, Phulwarisharif, Patna 801507, Bihār, India. dr.sony11776@aiimspatna.org
Received: March 12, 2026
Revised: May 8, 2026
Accepted: June 15, 2026
Published online: September 18, 2026
Processing time: 172 Days and 3.7 Hours
Revised: May 8, 2026
Accepted: June 15, 2026
Published online: September 18, 2026
Processing time: 172 Days and 3.7 Hours
Core Tip
Core Tip: Therapeutic penetrating keratoplasty is a surgical procedure wherein diseased infected host corneal tissue is replaced by a full-thickness donor cornea for eliminating infection and maintaining globe integrity. However, recurrence of infection in the graft remains a concern, especially in cases of resistant organisms such as Acanthamoeba, Pythium, or microsporidia or even in cases of some bacterial and fungal keratitis. The purpose of this review is to provide a comprehensive review and an update of peer-reviewed literature published over the last decade with emphasis on recalcitrant infections due to these pathogens.