Treatment of a Perforated Corneal Ulcer with Tectonic DSAEK: a Case Report

Modified “Top-up sandwich” technique for the management of corneal perforations: A case report and a literature review

“…This resulted in structural support, reepithelization and ocular surface healing. 4 To the best of our knowledge, only 11 cases were reported, where a tectonic posterior lamellar keratoplasty graft was used in the management of impending or actual perforation, Table 1 ., 4 , 5 , 6 , 7 , 8 Therefore this paper aims to add to the existing research by presenting our experience with posterior lamellar keratoplasty in the treatment of peripheral perforation cases. We have modified the original method by Graue-Hernandez et al for impending perforation 4 and termed it the “top-up sandwich technique.” The corneal surface is reinforced with a partial Gundersen flap externally in addition to a an external layer of amniotic membrane sandwiched between the perforation and a mini-posterior lamellar graft in the anterior chamber.…”