Results of Penetrating Keratoplasty for the Treatment of Corneal Perforations

Nobe, Janis R.

doi:10.1001/archopht.1990.01070090041035

Cited by 111 publications

(55 citation statements)

References 10 publications

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“…Although the use of keratoplasty to treat pathological corneas has been replaced almost entirely by penetrating keratoplasty (PKP) using viable donor corneas, [5][6][7][8][9][10][11] the supply of high-quality corneas is limited in many countries due to unreliable transportation, inconsistent distribution, and limited tissue shelf life. Glycerol preservation is a simple, effective technique that facilitates long-term storage of acellular corneal tissue for up to 5 years.…”

Section: Introductionmentioning

confidence: 99%

Eye preservation tectonic graft using glycerol-preserved donor cornea

Hc¹,

Sj²,

Chao³

2012

Eye

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Aims To report the surgical outcome of tectonic graft using glycerol-preserved donor corneas to treat perforated keratitis. Methods The medical records were reviewed of all patients treated for perforated keratitis using glycerol-preserved corneas at a single institution between 1 July 2004 and 31 June 2010. The clinical features, precipitating factors, adjuvant therapies, and therapeutic outcomes were analyzed. Success was defined as re-epithelialization of the ocular surface without evisceration. Results Fourteen eyes from 14 patients (6 male and 8 female) were included. Age ranged from 58 to 84 years (average, 70.71±8.52 years) and the follow-up time ranged from 7 to 56 months (mean, 25.35 ± 16.84 months). The culture results showed five bacterial infections, five cases of fungal keratitis, and one mixed infection; the culture results were negative for three patients. Satisfactory anatomical integrity was obtained in eight grafts (57.14%) that healed with neovascularization. Six grafts (48.85%) showed delayed re-epithelialization and were repaired with conjunctival flaps to maintain ocular surface integrity. Three patients developed secondary glaucoma and received trans-scleral cyclophotocoagulation. Thirteen patients had satisfactory anatomical integrity without evisceration or exenteration, while one patient received evisceration at 39-month follow-up because of intractable glaucoma. Conclusions Glycerol-preserved donor corneas combined with anterior vitrectomy with or without conjunctival flaps may be effective substitutes for evisceration surgery in patients with perforated keratitis.

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Section: Introductionmentioning

confidence: 99%

Eye preservation tectonic graft using glycerol-preserved donor cornea

Hc¹,

Sj²,

Chao³

2012

Eye

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“…[1][2][3][4][14][15][16][17][18][19] Failure to diagnose and treat a perforation early can lead to further corneal damage, cataract formation, secondary glaucoma due to formation of peripheral anterior synechiae, and loss of the eye, especially if the inflammatory response is marked. 15 Further, a delay in the management could result in amblyopia of the affected eye, especially when the central cornea is involved.…”

Section: Discussionmentioning

confidence: 99%

“…21 If these methods fail, then authors have described the use of conjunctival flaps, 22 AMT, 23 lamellar keratoplasty (LK), 24 deep lamellar keratoplasty (DLK), 25 patch graft, 12 or PKP. 18,19 Tissue adhesives can be used to close small perforation (up to 3 mm in diameter) and may slow down stromal melting. 21,26 Although Leahey et al 21 in a series of 44 patients (3 children) used cyanoacrylate glue to treat perforations, 2 children needed a subsequent conjunctival flap and PKP, resulting in poor visual outcome (see Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…16,17 In one such series of 46 eyes of 46 patients, only 2 were children and both had therapeutic PKP; 1 child had a failed PKP but was 6 months old and another child (5 years old) had successful PKP after initial glue for perforation due to HSK. 18 In one of the largest pediatric specific series of microbial keratitis, only 2 patients out of 78 presented with perforation. 30 Other techniques described to treat corneal perforations include LK or DLK, PKP with glycerin cryopreserved grafts and most recently crosslinking.…”

Section: Discussionmentioning

confidence: 99%

“…Although the literature has reports about management of bacterial and fungal keratitis in mixed cohorts of adults and children, 2,[14][15][16][17][18] especially in developing countries, there is little about the management of protozoal or viral keratitis and even less about non-infectious keratitis leading to perforation in children.…”

Section: Introductionmentioning

confidence: 99%

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

Medsinge

Gajdošová

Moore

et al. 2016

Eye

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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.

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