Management of inflammatory corneal melt leading to central perforation in children: a retrospective study and review of literature

Abstract

Purpose To assess the outcome of early therapeutic penetrating keratoplasty (PKP) for corneal melt leading to perforation in children.Methods Case notes of all the consecutive patients presenting with acute corneal perforation that underwent urgent therapeutic PKP between 2000 and 2010 to the practice of one of the authors, both NHS at Great Ormond Street Hospital for Children and private, were retrospectively reviewed. Onset of perforation, underlying cause, medical and surgical treatment, pre-and post-operative visual acuity, graft clarity, length of followup, and post-operative complications were recorded. Results Four eyes of four consecutive patients (mean age of 9.5 years and median 8.5 years, range 4-17 years) were treated for acquired acute onset corneal perforations. There were three females and one male.

Wet bio-amniotic membrane plugging combined with transplantation in the treatment of small corneal perforations

“…Corneal perforations are a potentially devastating late complications that can even cause precipitate corneal melting. For the treatment, PKP, amniotic membrane plugging, and amniotic membrane transplantation were reported effective for corneal perforations (17)(18)(19) . However, detailed reports on the treatment of small corneal perforations by the aforementioned methods are relatively limited, and their efficacy requires further investigation.…”

Tectonic keratoplasty using small incision lenticule extraction-extracted intrastromal lenticule for corneal lesions

“…1,[10][11][12] If left untreated, corneal thinning can result in perforation, which involves various complications including severe loss of anterior segment anatomical integrity, as well as endophthalmitis, panuveitis, secondary glaucoma, and irreversible vision loss. 2 Hence, timely diagnosis and proper intervention is needed to prevent these complications. Numerous treatment options are available based on the size and location of the lesion.…”

“…1 Urgent surgical intervention is therefore necessary to preserve the anatomic integrity of the eyeball and prevent disastrous complications such as retinal detachment, secondary glaucoma, endophthalmitis, and panuveitis. 2 Thus far, corneal gluing, bandage contact lens, amniotic membrane transplantation, and conjunctival flap can be used as temporary treatments for corneal lesions. 3,4 However, the long-term outcomes of bandage contact lens, multilayered amniotic membrane transplantation, and conjunctival flaps are unsatisfactory.…”

Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers

“…Once a corneal ulcer occurs and is left unattended, corneal melting, descemetocele, and corneal perforation can subsequently develop, leading to devastating consequences [3]. Moreover, when a resistant corneal ulcer progressively develops, lamellar keratoplasty or penetrating keratoplasty is usually needed [4, 5]. Therefore, curing a resistant ulcer in its early stages is highly recommended.…”