Abstract
Purpose. To report the surgical approach, anatomical and functional results, and complications in the group of patients with corneal perforation. Materials and Methods. 247 eyes with corneal perforation were operated on between January 2010 and July 2016. The three surgical procedures, dependent on size and location of perforation, were performed: full-sized penetrating keratoplasty, corneoscleral patch graft, and anterior lamellar keratoplasty. The eyes underwent the minimum 6-month follow-up visit. Results. Between January 2010 and July 2016, 247 surgeries were performed: 116 penetrating keratoplasties, 117 corneoscleral patch grafts, and 14 anterior lamellar keratoplasties. More than one procedure was necessary in 32 eyes. Final improvement of the visual acuity, within a gain of 2 or more lines with the Snellen test, was achieved in 56 operated eyes. To achieve better final visual acuity, 75 eyes required successive surgical treatment. Complications of the surgery comprised persistent epithelial defect, glaucoma or ocular hypertension, corneal oedema, graft melting, loose corneal sutures, reinfection, anterior synechiae and fibrinoid membranes, and endophthalmitis. In 26 eyes, the treatment failure was reported. Conclusions. There is no one general-purpose surgical technique to treat corneal perforations. The complex nature of this pathology remains the individual, careful but also very distinct and multifactorial approach.
Highlights
Corneal perforation is a common condition, and it can lead to profound vision loss and severe ocular morbidity
The aim of this study is to report on a sample of patients who underwent surgical treatment for corneal perforation
This study was a retrospective review of the surgical treatment of 247 eyes with corneal perforation, which were operated between January 1, 2010, and July 31, 2016, at the Ophthalmology Department of Saint Barbara Hospital, Trauma Center, Sosnowiec, Poland
Summary
Corneal perforation is a common condition, and it can lead to profound vision loss and severe ocular morbidity. It can be caused by infection, bacterial and noninfectious ocular surface disorders, immune disorders, and trauma. Other conditions such as xerosis, exposure, neurotrophic disorders, corneal degeneration, and ectasia and surgical and toxic/keratolytic treatment can lead to corneal perforation. The therapeutic procedure and its timing depend on various conditions, such as cause, location, size of perforation, corneal infiltration and melting, and state of internal globe tissues [1, 4,5,6,7]
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