Abstract: Objective To evaluate the efficacy and safety of deep lamellar keratoplasty (DLKP) and penetrating keratoplasty (PKP) in the treatment of fungal keratitis.Methods Forty-four patients (44 eyes) were diagnosed as fungal keratitis and no obvious effect with drug treatment. DLKP (28 cases, 28 eyes) or PKP (16 cases, 16 eyes) was performed according to whether involved corneal endothelium by confocal laser microscopy. Patients were followed up for 6 to 24 months to observe recurrence postoperation, visual acuity and corneal topography astigmatism two weeks after suture removal.Results Corneal histologiacal examinations of all cases were detected of fungus. One eye by DLKP and three eyes by PKP appeared graft edema and improved after anti-rejection therapy. The best corrected visual acuity (BCVA) of DLKP group was 0.59±0.04, and BCVA of PKP group was 0.41±0.05,there was significant statistically difference (t=2.577,P=0.01). The corneal topographic astigmatism of DLKP group was (2.0±0.17)D, and that of PKP group was (2.9±0.30)D, there was statistically difference (t=0.088,P=0.016).Conclusions Laser confocal microscopy is helpful in the diagnosis of fungal keratitis and in judging the depth of the filament infiltration, providing a favourable objective evidence for choice of surgical methods. Both methods have good effects in treatment of fungal keratitis. The visual functional of DLKP is outshine than that of PKP.

Key words: fungal keratitis, deep lamellar keratoplasty, penetrating keratoplasty