Research Article Total Penetrating Keratoplasty: Indications, Therapeutic Approach, and Long-Term Follow-Up Katarzyna Krysik , 1 Ewa Wroblewska-Czajka, 2 Anita Lyssek-Boron, 1 Edward A. Wylegala, 2,3,4 and Dariusz Dobrowolski 1,2,3 1 Department of Ophthalmology with Pediatric Unit, St. Barbara Hospital, Trauma Center, Medykow Square 1, 41-200 Sosnowiec, Poland 2 Department of Ophthalmology, District Railway Hospital, Panewnicka 65 St., 40-760 Katowice, Poland 3 Chair and Clinical Department of Ophthalmology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Panewnicka 65 St., 40-760 Katowice, Poland 4 Hebei Provincial Eye Hospital, Xingtai, China Correspondence should be addressed to Dariusz Dobrowolski; dardobmd@wp.pl Received 5 November 2017; Accepted 22 January 2018; Published 19 April 2018 Academic Editor: Zisis Gatzioufas Copyright © 2018 Katarzyna Krysik et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. Evaluation of the indications, anatomical and functional results, and complications of total penetrating keratoplasty (TPK) in disorders involving whole cornea. Materials and Methods. We analyzed outcomes of the surgical treatment of 47 eyes of 46 patients that underwent TPK. Indications were infectious keratitis, autoimmune disease, injury of the eyeball (mainly chemical burns), and other combined disorders. The surgical technique involved dissection of affected tissues with a margin of 1.0 mm. The size of the corneal graft ranged from 10.0 to 14.0 mm. We analyzed indications, outcomes, and complications of surgery. Results. Final restoration of the ocular integrity and maintenance of the globe were achieved in 27 eyes (57%). More than one surgery was necessary in a total of 29 eyes (62%). The frequency of retransplantations did not vary significantly between the groups with different causes of corneal melting/perforation (63% of eyes with infection, 66% of eyes after trauma and 70% of eyes of patients with autoimmune disorders). Surgical treatment failed in 20 eyes (43%). Evisceration was necessary in 13 eyes (28%), phthisis occurred in 7 cases (15%). Conclusion. TPK should be considered as a last line treatment in huge corneal destruction to restore integrity of the eye globe. 1. Introduction Serious corneal disorders like ulcers or perforations frequently give rise to difficult clinical situations, with rapid consecutive threatening of vision and disintegrity of the eye globe. Despite current advances in pharmacological and surgical treatment, severe corneal infections, injuries, or systemic diseases can lead to corneal perforations, which frequently require surgery “à chaud.” Urgent reconstructive surgical interventions may be nec- essary to avoid consecutive endophthalmitis and the forma- tion of the anterior and posterior synechiae and secondary glaucoma and to prevent the spread of pathogens toward the posterior pole of the eye globe or to avoid other severe complications [1–4]. The optical result of urgent surgical treatment is less important; if possible, visual restoration or rehabilitation may be accomplished in the future. Initial dif- ficult and complicated medical status, despite a wide spec- trum of pharmacological and surgical treatments, may result in fatal treatment failure with loss of the eye. The poor visual outcome of rapid corneal surgery may require further surgery [1, 4–6]. The surgical approach to retain corneal integrity may vary, depending on size, localization, depth of corneal tissue damage, and the state of other internal globe tissues. Also, coexistent or causative infection or inflammation may deter- mine the choice and timing of surgical decisions. Additional surgical procedures like amniotic membrane transplants, Hindawi Journal of Ophthalmology Volume 2018, Article ID 9580292, 6 pages https://doi.org/10.1155/2018/9580292