Management Of Corneal Perforations Research Articles

Tenon Patch Graft in The Management of Corneal Perforations: A case series

Introduction : A full-thickness defect of the cornea that results in a rupture or opening is known as corneal perforation. Despite corneal transplant being the gold standard therapy, finding a donor remains challenging. Tenon patch graft (TPG) may be the alternative surgical procedure to repair the damaged cornea. This case series presents six cases of corneal perforations that have been effectively managed with TPG.
 Case Illustration : Six cases with corneal perforations in the age range of 6-75 years old were presented with varying perforation sizes ranging from 0.5 to 8 mm. The most common complaints were vision loss, redness, and watery eyes. Ophthalmology examinations revealed five corneal ruptures and one impending corneal rupture caused by trauma, infections, corpus alienum, and post-operative. All patients underwent TPG surgery with compression/infinity sutures using 10-0 nylon, followed by bandage contact lenses, with three adjoined with amniotic membrane transplant. Post TPG, patients were followed up for 1-4 months and no complications such as glaucoma, cataract, or endophthalmitis were found.
 Discussion : Corneal damage that is not treated promptly causes further erosion of the deeper corneal layers. When medication fails, other measures must be taken to preclude further damage. TPG may be an accessible and cost-effective surgical procedure of choice to preserve eye integrity both functionally and structurally.
 Conclusion : This case series of tenon patch grafts for corneal perforations less than 9 mm demonstrated the effectiveness of TPG in promoting corneal healing without significant complications. Despite differences in perforation size and patient characteristics, all six cases saw closure of the perforation.

Efficacy of Cyanoacrylate Tissue Adhesive Application in the Management of Corneal Perforations at Preah Ang Duong Hospital in Cambodia

Efficacy of Cyanoacrylate Tissue Adhesive Application in the Management of Corneal Perforations at Preah Ang Duong Hospital in Cambodia

Review on corneal perforation among mentally disabled patients in a tertiary center in Melaka, Malaysia

Corneal perforation is an ocular emergency arising from various causes of infectious and non-infectious disease. Its management could range from temporising measures to various surgical intervention. This study was done to evaluate the causes and management of corneal perforation among mentally disabled patients in Melaka. Retrospective review was done using the ward admission records from 2019 to 2022. Data gathered from cases with corneal perforation was reviewed. There were total of 15 patients with 8 (53.4%) males and 7 (46.6%) females. Out of these, 10 (66.6%) patients are mentally disabled. Majority of the patients (73%) were more than 50 years old. The visual acuity at presentation was poorer than 3/60 in 12 (80%) patients, out of which 10 (83%) patients are mentally disabled. There was a high proportion of perforation, 12 (80%) caused by infective keratitis which is also the main cause of perforation among disabled patients. Among the mentally disabled patients, 5 patients (50%) underwent evisceration, 4 patients (40%) underwent conjunctival flap and 1 patient (10%) was managed conservatively. Comparing with the patients without disability, 2 (40%) patients underwent tectonic keratoplasty, 2 (40%) patients underwent evisceration and 1 (20%) patient underwent conjunctival flap. People with disabilities experience worse health and poorer access to health care compared to people without disability. The presenting visual acuity in the disabled group is poorer. The main cause of corneal perforation among mentally disabled was infection and the options of treatments mainly were conjunctival flaps and evisceration.

Management of Corneal Perforation by Conjunctival Covering at the Bougouni Reference Health Center: A Series of Five (5) Cases

Introduction: Corneal perforations are a major cause of ocular morbidity and blindness. Several surgical techniques can be used to treat them, including conjunctival covering, which has numerous therapeutic properties and reduces the risk of anatomical loss. Observation: We present a series of five (5) cases admitted to the ophthalmology department for ocular pain, in whom the clinical examination concluded a corneal perforation. The etiologies were traumatic in three patients, Mooren's ulcer in one and undetermined in another. Conjunctival covering was the technique used to manage the patients. Visual acuity improved in two of our patients after surgery, and remained almost unchanged in one. Two patients were lost to follow-up. Conclusion: Despite the advancement and promotion of new techniques, conjunctival covering still has its place in the management of corneal perforations, especially when the technical platform is weak.

Management of a central corneal perforation in the emergency room: Tenon patch technique.

PurposeCorneal perforations are defined as a solution of continuity in the cornea. Usually, these cases evolve to the formation of a corneal-iridial scar or require surgical intervention. The tenon patch graft represents a good alternative to other methods and has many advantages.ObservationA 63-year-old patient who had been followed for severe dry eyes due to rheumatoid arthritis for 10 years presented to the emergency room with a central corneal perforation, partially sealed by the iris, accompanied by significant corneal edema in the right eye. Given the clinical picture that had been developing for 5 days, we decided to perform a tenon patch graft on the perforation. At 4 weeks of follow-up, globe integrity was maintained with a well-placed tenon patch. No evidence of leakage in the Seidel test was noted.ConclusionThe tenon patch graft represents a good alternative in the management of corneal perforations and has many advantages, among which the feasibility in an emergency, allowing a corneal graft afterwards.

Management of corneal perforations: An update.

Corneal perforation is a potentially devastating complication that can result from numerous conditions that precipitate corneal melting. It is associated with significant morbidity and prompt intervention is necessary to prevent further complications. Causes include microbial keratitis, ocular surface disease, and autoimmune disorders and trauma. Various management options have been described in the literature to facilitate visual rehabilitation. This rview discusses the treatment options that range from temporising measures such as corneal gluing through to corneal transplantation, with decision making guided by the location, size, and underlying aetiology of the perforation.

Cyanoacrylate tissue adhesive for the management of corneal perforation in dogs:a report of three cases

Corneal perforation can cause profound vision loss and requires immediate treatment. Bandage contact lens insertion and gluing are temporary treatment methods. However, if the patient cannot undergo surgery for a variety of reasons, these methods are inevitably used as permanent treatment methods. The use of cyanoacrylate tissue adhesive (CTA) for the management of corneal perforation in humans has been reported for several decades. Here we describe, for the first time as per our knowledge, the use of CTA (Vetbond) for the management of corneal perforation with a diameter of

Double Drape Tectonic Patch With Cyanoacrylate Glue in the Management of Corneal Perforation With Iris Incarceration

*Department of Ophthalmology, University Hospital of Leicester NHS Trust, Infirmary Square, Leicester, United Kingdom †Department of Ophthalmology, Nottingham University Hospital NHS Trust, Nottingham, United Kingdom Financial disclosures/conflicts of interest: None reported.

Therapeutic penetrating keratoplasty: clinical outcome and evolution of endothelial cell density.

To identify the influence of the underlying etiology on the outcome of therapeutic penetrating keratoplasty (PKP) in the management of corneal perforation, impending perforation or refractory corneal disease. A retrospective observational case series with 28 patients (28 eyes) was performed. Patients were divided in two subgroups, based on the underlying ocular disease leading to the therapeutic PKP. Group I consisted of 15 patients (54%) with an infectious etiology, the other 13 patients (46%) with a noninfectious condition belonged to group II. Mean follow up was 23.2 months (median 21 months). An enucleation could be avoided in all but two cases. In group I, 12 of 15 (80%) grafts remained clear, compared with only 3 of 13 (23%) in group II (p = 0.0004). Visual acuity (VA) amelioration was achieved in 20 of 28 patients (71%). In group I the postoperative VA was significantly better than preoperatively (p = 0.002); however, in group II the improvement was only borderline significant (p = 0.05). Overall five out of ten (50%) patients with a therapeutic PKP in group I had an endothelial cell density >or= 1900 cells/mm2 at the time of their last specular microscopy. Our study demonstrates the importance of underlying etiology on the outcome of therapeutic PKP. Graft survival and postoperative visual acuity varied widely depending on the underlying ocular disease, and it was clear that therapeutic PKP has a much better prognosis in infectious conditions when compared with noninfectious conditions. We believe that these good results can justify the use of therapeutic PKP in selected cases of infectious keratitis.