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Systemic tuberculosis mostly affects the lungs and ocular involvement is rare. The ocular manifestations are varied, and rarely peripheral ulcerative keratitis (PUK) occurs either due to direct invasion of the microorganism or due to immune reaction. We present a case of advanced PUK in a 28-year-old male patient diagnosed with pulmonary TB in the right eye with hourglass cornea. The ulcer was progressing circumferentially with necrosis of corneal stroma and undermined margins similar to Moorens ulcer, and was not responding to anti-tuberculosis treatment and topical steroids. We describe a modified novel surgical technique using tenons sling annular patch graft to manage the progressive advanced PUK with hourglass cornea to optimize visual and structural outcome in our patient.

Purpose Covid-19 has profoundly affected the day-to-day lives of individual citizens. It has strained all aspects of health care including eye banking and corneal transplantation. Although elective procedures like optical Keratoplasty can be postponed, management of perforating ulcers needs tectonic Keratoplasty to avoid permanent ocular morbidities. It has become inevitable for corneal surgeons to innovate newer methods of treatment for such corneal diseases. The large corneal perforations if left untreated may lead to permanent visual loss. An alternative method of managing a large peripheral corneal perforation of size 5 × 5.5 mm was done using Tenons patch graft with Gore-tex in a 50-year-old female patient, during the lockdown. Observations Tenons graft with Gore-tex, effectively sealed the large corneal perforation in our case without iris incarceration, favourable for future visual rehabilitation. Conclusions and Importance Tenons and Gore-tex are readily available. It is not necessary to rely on the donor corneas or the distributing eye banks during this pandemic situation. In the future, this procedure can reduce the burden of the pre-existing increase in the gap between the need and supply of donor corneas in developing countries.

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Purpose: To analyze the impact on eye donation and corneal transplantation during the COVID-19 pandemic in a tertiary eye hospital in south India. Methods: A retrospective analysis of the donor and recipient records during the study period from January 2020 to May 2021 was conducted and tabulated in Microsoft Excel 2013. Demographic details of the donor, utility rate, cause of death, culture characteristics, storage methods, wet lab usage, and the surgical donor outcomes were evaluated. Additionally, the postoperative workup of the recipients, diagnosis, graft infection and rejection episodes, development of COVID-19 postoperatively, and outcome in terms of visual acuity at one, three, and six months were also noted. Results: A total of 466 eyes from 249 donors were received during the study period. The mean age of the donor population was 62.43 years (20.9). The corneal transplantation utility rate was 36.4% ( n = 170). Fifty-one percent of the total transplant surgeries were for therapeutic purposes. This was followed by penetrating optical keratoplasty (34%), Descemet’s stripping endothelial keratoplasty (9%), and patch grafts (3%). Seventeen (10%) graft rejection episodes were noted and nine (53%) had complete resolution after medical treatment. Conclusion: Proper preventive measures are key to carrying out safe and efficient eye banking activities even during a deadly pandemic, as COVID-19 transmission via transplantation is rare.