Abstract
Corneal perforations pose a considerable challenge for ophthalmic surgeons. The aim remains restoring the anatomical integrity of eye while attempting to preserve as much visual function as possible. To our knowledge, we report the first case series of 4 successful tectonic Descemet stripping endothelial keratoplasty (DSEK) grafts completed for acute corneal perforation. In all cases, restoration of globe integrity was achieved. In cases where visual potential remained, deep anterior lamellar keratoplasty over DSEK was offered. Four patients presenting to Royal Gwent Hospital (Newport, Wales) with corneal perforation were included. Etiological origins included exposure keratopathy, corneal hydrops secondary to pellucid marginal degeneration with fistulization-associated aqueous leak, and herpetic keratitis. Patients were treated with initial temporary therapies, including glue patch, the use of bandage contact lenses, amniotic membrane transplant, and antibiotic cover, depending on the size and location of the perforation. Subsequent DSEK was subsequently performed under local anesthesia. All patients had successful tectonic grafts (3 DSEKs and 1 hemi-DSEK) up to 4 months postoperatively. In the case involving a hemi-DSEK, the patient underwent 2 refloating attempts of the graft before anchoring suture placement because of repeated graft detachment. Successful graft placement and tectonic globe restoration was confirmed by anterior segment imaging. Tectonic DSEK provides corneal surgeons with a new modality of treating corneal perforations. It provides clinicians an additional tool in their armamentarium in complex cases where anterior lamellar or penetrating keratoplasty may be contraindicated or deemed high risk of complications.
Full Text
Topics from this Paper
Descemet Stripping Endothelial Keratoplasty
Corneal Perforation
Use Of Bandage Contact Lenses
Deep Anterior Lamellar Keratoplasty
Successful Graft Placement
+ Show 5 more
Create a personalized feed of these topics
Get StartedTalk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Similar Papers
The Ocular Surface
Oct 1, 2019
Eye (London, England)
Nov 3, 2022
Canadian Journal of Ophthalmology
Jun 1, 2023
Ophthalmology
Mar 1, 2013
Cornea
Jan 1, 2014
Xenotransplantation
Apr 10, 2019
Eye and Vision
Jul 14, 2015
Cornea
Cornea
Nov 28, 2023
Cornea
Nov 28, 2023
Cornea
Nov 28, 2023
Cornea
Nov 28, 2023
Cornea
Nov 27, 2023
Cornea
Nov 27, 2023
Cornea
Nov 27, 2023
Cornea
Nov 27, 2023
Cornea
Nov 22, 2023
Cornea
Nov 22, 2023