September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Non-Traumatic Corneal Perforations: Etiology, Treatment and Outcomes
Author Affiliations & Notes
  • Denise Loya
    Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Juan Carlos Serna-Ojeda
    Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Lucero Pedro Aguilar
    Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Aida Jimenez-Corona
    Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Andrew Olivo-Payne
    Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Erick Hernandez-Bogantes
    Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Arturo J Ramirez-Miranda
    Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Alejandro Navas
    Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Alejandro Lichtinger
    Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Enrique O Graue-Hernandez
    Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Footnotes
    Commercial Relationships   Denise Loya, None; Juan Carlos Serna-Ojeda, None; Lucero Pedro Aguilar, None; Aida Jimenez-Corona, None; Andrew Olivo-Payne, None; Erick Hernandez-Bogantes, None; Arturo Ramirez-Miranda, Carl Zeiss Meditec (C); Alejandro Navas, Alcon laboratories (C); Alejandro Lichtinger, None; Enrique Graue-Hernandez, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1239. doi:
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      Denise Loya, Juan Carlos Serna-Ojeda, Lucero Pedro Aguilar, Aida Jimenez-Corona, Andrew Olivo-Payne, Erick Hernandez-Bogantes, Arturo J Ramirez-Miranda, Alejandro Navas, Alejandro Lichtinger, Enrique O Graue-Hernandez; Non-Traumatic Corneal Perforations: Etiology, Treatment and Outcomes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1239.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : To report etiology, characteristics, treatment and main outcomes of non-traumatic corneal perforations in a single referral center.

Methods : A retrospective review of clinical records of patients diagnosed with non-traumatic corneal perforation treated over a 5-year period were analyzed. The data included demographic characteristics, medical history, initial and final corrected distance visual acuity (CDVA), perforation etiology (non-infectious and infectious), size, location, initial therapy, surgical treatment, ocular integrity and complications. The comparison in the distribution between the non-infectious and infectious groups was performed with a Pearson's chi-squared test. Different variables were analyzed through a multiple logistic regression analysis for the probability to have a second procedure(s).

Results : We included 127 eyes of 116 patients (69 female and 47 male) with a mean age of 50 years (range 5 to 81 years) and a mean follow up of 11 months. Eleven patients presented bilateral corneal perforation, 9 of which had rheumatoid arthritis (RA). The most common systemic comorbidity was RA (44.8%). The initial CDVA was 3.00 logMAR and the final CDVA was 2.30 logMAR (p>0.56). Regarding treatment, of the 49 eyes with an initial cyanoacrylate patch, 14 (28.6%) eyes did not required any further treatment; whereas 35 eyes (71.4%) had at least one more procedure (p>0.001). In comparison, of the 49 eyes with an initial tectonic keratoplasty, 33 (67.3%) eyes remained stable while 16 (32.7%) eyes needed one or more interventions (p=0.004). In a multiple logistic regression analysis an initial cyanoacrylate patch represented a probability of 4.7 times to require a subsequent procedure. Overall, ocular integrity was achieved in 96.1% of the cases.

Conclusions : Corneal perforations represent an important cause of ocular morbidity. An appropriate treatment should be based according to etiology, size and location of the perforations. The use of a cyanoacrylate patch is useful as an initial therapy in small and central perforations, however, procedures such as keratoplasty or amniotic membrane grafts may be necessary to achieve anatomical success.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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