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Purpose: To evaluate anatomical and functional prognosis of urgent penetrating keratoplasty in perforated infectious corneal ulcers., Methods: Seven eyes of seven patients had an urgent penetrating keratoplasty for perforated infectious corneal ulcers. Anatomical success was defined by eradication of infection and preservation of eye from enucleation and phthisis bulbi. Corneal graft survival was defined by the presence of a clear graft., Results: The patients'mean age was 40.5 years. Four eyes had bacterial corneal ulcer and three eyes had herpetic corneal ulcer. Anatomical success was obtained in six eyes. The graft remained clear in two eyes. Graft rejection was noted in four eyes after a mean period of 4.5 months. Postoperative complications were ocular inflammation (one eye), ocular hypertension (three eyes), cataract (one eye), peripheral anterior synechiae (one1 eye), graft ectasia (one eye), bacterial infection (one eye) and recurrent herpetic keratitis (one eye). The mean follow-up period was 22 months, ranging from 9 to 32 months., Conclusion: Urgent penetrating keratoplasty can preserve eye integrity and eradication of the infectious process in a large part of perforated bacterial and herpetic corneal ulcers. Visual rehabilitation is often a secondary objective. Adapted antimicrobial treatment reduces graft reinfection and steroid treatment reduces the frequency of some complications, especially graft rejection.

We report a case of herpetic perforated peripheral corneal ulcer in a patient with cutaneous porphyria and hepatitis C. The patient underwent peripheral lamellar keratoplasty. Antiherpetic antibodies were found at a significantly higher level in the aqueous humor than in the serum. Outcome was favorable with antiviral treatment. We discuss the causal role of the hepatitis C virus, porphyria and herpes simplex.

Objectives: To study the frequency of ocular hypertension in uveitis and its correlations with the characteristics of uveitis. To analyze the mechanisms of hypertension and the influence of different etiologies. To evaluate the prognosis of increased intraocular pressure secondary to uveitis., Material and Methods: Retrospective, single-center, mono-observer study of 374 consecutive cases of uveitis., Results: Ocular hypertension was observed in 45 of 374 cases (12%). Hypertension was observed only in 2 cases without any sign of anterior chamber inflammation. Increased intraocular pressure was more frequently observed in granulomatous uveitis [15 of 33 cases (45.4%)] than in non granulomatous uveitis [30 of 341 cases (8.9%)] (p < 0.001). There were 2 cases of Posner-Schlossman syndrome. Herpetic uveitis was otherwise the most frequent etiology of uveitis associated with secondary ocular hypertension [8 of 22 cases (36.3%)]. The ocular hypertension was most often in phase with intraocular inflammation [17 of 45 cases (37.8%)], suggesting a mechanism of trabecular obstruction. Corticosteroid-induced hypertension was only noted in 2 cases. In 12 cases the mechanisms of ocular hypertension could not be determined. Glaucomatous optic neuropathy was only observed in 3 patients. Filtering surgery was performed in 4 cases., Conclusions: Among uveitis cases, findings linked to a higher frequency of ocular hypertension were identified. There was a discrepancy between the low frequency of corticosteroid induced hypertension and the broad use of topical corticosteroids in cases of uveitis. The analysis of the mechanisms involved is necessary for an adequate treatment. The prognosis of hypertensive uveitis was more frequently linked to the consequences of intraocular inflammation than to hypertension.

Seventeen patients with presumed chronic herpetic uveitis of all anatomic types underwent systemic treatment with oral and/or intravenous, acyclovir. The diagnosis of herpes had been established on data from serological tests of the aqueous humor. Results were judged according to corticodependance and visual acuity. Results were all the more positive as treatment was more prolonged and also correlated with the dose of acyclovir injected intravenously or taken orally every day. Follow-up ranged from 6 months to several years.