الفهرس 
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Abstract
The importance of corneal disease as the second major cause of blindness worldwide (second only to cataract) is unquestionable. Its epidemiology is complicated and encompasses a wide variety of infectious and inflammatory eye diseases.
Penetrating keratoplasty (PKP) involves surgical removal of the diseased or damaged cornea from the host and its replacement by a full thickness donor cornea. The major goals of PKP are to improve visual acuity, maintain the integrity of the eye, and treat various corneal infections.
The aim of our study was to compare the rate of endothelial cell loss (ECL) following penetrating keratoplasty (PKP) for optical and therapeutic indications.
The study enrolled two groups; group 1 included 30 corneas of 30 patients which performed optical PKP for various purposes, while group 2 comprised 30 corneas of 30 patients which were planned for performing therapeutic PKP for un-healed, resistant corneal infections.
The mean patients’ age in group 1 and 2 was 43.70 ± 14.79 and 47.27 ± 14.51 years, respectively. The female to male ratio for group 1 was 1:1.33 and for group 2 was 1:1.42, and the percentage of right to left eyes was 44.9% to 55.1% for group 1 and 54.3% to 45.7% for group 2. There were no statistically significant differences between the two groups regarding any of these demographic parameters.
There were no statistically significant differences between both groups regarding the indications for the PKP, the donor’s age, the time interval from death to the time of graft preservation and the preservation time of the graft. However, the initial ECD of the donor’s graft it was significantly lower in group 2 compared to group 1.
There was also no statistically significant difference in the number of graft rejection or steroid responders between both groups.
As regards to the graft clarity, 90.4% and 77.2% of the grafts of groups 1 and 2, respectively, gained clarity at the 10th post-operative day, with no statistically significant difference between both groups. The graft clarity reached 100% for both groups by the 1st month follow up visit.
Regarding the rate of ECL at the 3-, 6- and 12-months postoperatively, no statistically significant differences were found between both groups at the 3- and 6-months intervals, yet the rate of ECL was significantly higher in group 2 compared to group 1 at the 12- month interval (P-value<0.05).
In conclusion, this study results declared that therapeutic PKP can be considered non-inferior to optical PKP regarding the rate of graft rejection, the graft viability, and the rate of ECL along a follow up interval of one year. Hence, it can be considered as a safe alternative for cases with infected corneal ulcers which are resistant to the conventional medical therapies. Further long-term longitudinal studies are needed to validate or contradict our study results and to determine whether the change that was detected in the rate of ECL at the 12 months interval in cases of therapeutic PKP is an ongoing process that may progressively affect the graft survival or it is a stationary loss rate.