Ocular Microbiology and Immunology Group
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2025 OMIG Abstract

Therapeutic Penetrating Keratoplasties in the Last 3 Years: A Subgroup Analysis for a Pilot Corneal Ulcer Clinic

Nicholas Joseph DeLuca^1,2, Belen Wertheimer^1,2, Sebastian Borges^1,2, Guillermo Amescua<sup>2

1</sup>University of Miami Miller School of Medicine, Miami, Florida; ²Bascom Palmer Eye Institute,
University of Miami Health System, Miami, Florida

Purpose: To evaluate the impact of a dedicated Corneal Ulcer Clinic (CUC) on visual outcomes, microbial profiles, and surgical intervention rates in patients with infectious keratitis at a tertiary eye center.

Methods: A retrospective cohort study was conducted at a tertiary eye center between January 2022 and April 2025. Outcomes included visual acuity (logMAR), graft failure, and surgical conversion. Interrupted time series (ITS) analysis and binomial logistic regression assessed changes in TPK rates following the June 2024 clinic launch. Statistical comparisons used Wilcoxon, Kruskal-Wallis, Dunn, Mann-Whitney U, and regression models.

Results: Among 115 TPK and 117 CUC patients, CUC management was associated with improved visual acuity at 1 month (p = 0.018). Among TPK patients followed in the CUC, visual acuity improved significantly by 6 months (p = 0.043). Among patients who underwent corneal transplant, graft failure occurred less frequently in the CUC group (18.8% vs. 33.9%), although this difference was not significant (p = 0.267). Fungal infections had better 1-year visual acuity than bacterial etiologies (p = 0.0347). ITS analysis from 2022-2025 revealed no significant level or trend change in TPK rates after clinic implementation (β = -0.000599, p = 0.718). Logistic regression adjusted for time similarly found no significant difference in the odds of TPK in the post-clinic period (OR = 1.08, 95% CI: 0.536–2.22, p = 0.83).

Conclusions: Implementation of a dedicated Corneal Ulcer Clinic was associated with improved visual outcomes, including among patients who ultimately required surgical intervention, but did not lead to a statistically significant reduction in TPK rates in the short term. This pilot study suggests that structured care pathways for microbial keratitis may enhance clinical recovery and represent a promising strategy to improve outcomes and optimize healthcare resource utilization, even without immediate changes in surgical volume.