Simplified technique for sealing corneal perforations using a fibrin glue-assisted amniotic membrane transplant-plug.

Selcuk Kara,Ismail Ersan,Sedat Arikan,Arzu Taskiran Comez

doi:10.1155/2014/351534

Selcuk Kara, Ismail Ersan + Show 2 more

Open Access

https://doi.org/10.1155/2014/351534

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Abstract

Purpose. To describe a surgical technique using amniotic membrane transplant (AMT) with fibrin glue (FG) for treating smaller corneal perforations more practically and appropriately filling the defect. Method. A patient with noninfectious central corneal perforation, in 1 mm in diameter, was treated with FG-assisted AMT-plug. An AMT was folded in on itself twice by using FG then a small piece of this FG-AMT mixture was cut to maintain an appropriate plug for the site of the corneal perforation. The FG-assisted AMT-plug was placed in the perforation area by using FG. An amniotic membrane patch was placed over the plug, which was then secured by a bandage contact lens. Result. Surgery to restore corneal stromal thickness without recurrence of perforation. Conclusion. The FG-assisted AMT-plug allowed a successful repair of 1 mm in diameter corneal perforation. This technique was easily performed, thus seeming to be a good alternative to treat corneal perforations with restoring corneal thickness.

Highlights

Corneal perforations presenting as a result of infection, inflammation, or trauma are ophthalmic emergencies that urgently require appropriate intervention
The tissue adhesives cyanoacrylate and fibrin glue are widely used in smaller corneal perforations, they cannot be sustained in the defect site as a filling material [6]
We present an intervention of FGassisted amniotic membrane transplant (AMT)-plug for a corneal perforation of 1 mm in diameter and evaluate the corneal stroma stability until keratoplasty

Summary

Introduction

Corneal perforations presenting as a result of infection, inflammation, or trauma are ophthalmic emergencies that urgently require appropriate intervention. Kim and Park reported on a way to eliminate the limitations of multilayer AMT [10] They maintained a thick single piece of 5- or 7-ply AMT by using fibrin glue (FG) between the sheets, a method called “augmented AMT,” and successfully treated corneal perforations in a range of 2–5 mm in diameter. This technique is very useful for larger corneal perforations, it is relatively difficult to prepare FG-assisted multilayer AMT and there is no need for the manipulation of separate pieces of AMT in small perforations. During the 5-month follow-up period of this patient after surgery and before the keratoplasty, the corneal integrity was stable and there was no recurrence of the epithelial defect

Surgical Technique

Findings

Discussion