Therapeutic deep anterior lamellar keratoplasty for eccentric corneal perforations

Abstract

Objective To demonstrate the efficacy of deep anterior lamellar keratoplasty for the treatment of eccentric corneal perforations.Methods It was a retrospective case series study.Deep anterior lamellar keratoplasty (DLKP) was performed on 11 patients with infected or noninfected corneal perforations from December 2008 to January 2011.The corneal perforations were located between the pupillary edge and limbus with diameters ranging from 1.5 mm to 2.0 mm.Postoperative visual acuity,intraocular pressure, endothelial cell density, transparency rate, corneal neovascularization, graft rejection and ulceration recurrence were recorded.Results Patients were followed postoperatively for 12-24 months (mean 17.5±3.7 months).The majority (10 eyes) had excellent engomphosis between the graft and recipient bed.Graft opacity was observed in 1 patient with rheumatoid arthritis and drug allergy due to the formation of a double anterior chamber at the ulceration site. All other patients had clear corneas, apart from the area of the original perforation. The integrity of the globe was restored in all 11 patients with an improvement in visual acuity (0.04 in one,and 0.1 or better in ten) and normal intraocular pressure.The average endothelial cell density after DLKP was 2286±293 cells/mm2. Immune graft rejections, ulceration recurrence and corneal neovascularization were not observed in any patient during the follow-up period. Conclusion DLKP is a safe and effective therapeutic measure in the management of patients with small eccentric corneal perforations. Key words: Corneal ulcer; Perforation; Deep anterior lamellar keratoplasty; Corneal diseases