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Hyung-Joon Kim, Jung-Hoon Lee; Therapeutic Keratoplasty Using Cryo-preserved Human Cornea For The Urgent Treatment Of Perforated Cornea Due To Infectious Keratitis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6043.
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To investigate the clinical outcome of patients and the effect of tectonic graft using preserved human corneal tissue for the urgent treatment of corneal perforations caused by infectious corneal ulcer when fresh donor corneas were not readily available.
10 Eyes with intractable infectious keratitis which developed corneal perforation larger than 2mm were surgically treated with urgent tectonic graft using human corneal tissues preserved in Optisol and Glycerol in -80° C. Subsequent penetrating keratoplasty were performed and evaluated more than 12 months.
In our study, 5 eyes had bacterial keratitis, 3 eyes had fungal keratitis, and 2 eyes had herpes simplex keratitis. After the initial graft, anatomical success was achieved in 8 eyes. In two eyes, a graft melting was developed secondary to delayed epithelial healing. Visual acuity was improved in all 7 eyes that received subsequent penetrating keratoplasty and no rejection was developed during the follow-up period of more than 12 months.
Tectonic keratoplasty using preserved human corneal tissue for urgent purpose is a useful method for preservation of the globe & management of infection when fresh donor corneas were not readily available. The timing of surgery is critical for good therapeutic outcomes, because scleral or intraocular extension of infection is likely to result in poorer outcomes. To enhance the anatomical success of the graft, the healing of the overlying epithelium & control of glaucoma is very important.
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