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H.-J. Kim, S. Kim; Effect of Tectonic Graft Using Preserved Human Scleral Tissue for the Urgent Surgical Treatment of Corneal Perforation Due to Infectious Keratitis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1510.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the effect of tectonic graft using preserved human scleral tissue for the urgent treatment of corneal perforations caused by infectious corneal ulcer
10 eyes with intractable infectious keratitis developed corneal perforation larger than 2mm together with severely melted adjacent stroma. All the eyes were surgically treated with a urgent tectonic graft using preserved human scleral tissue for the preservation of the ocular structure. Melted corneal tissue together with fibrotic tissue were widely excised and human scleral tissue that were preserved in 70 % alcohol after the keratoplasty were grafted with 16 interrupted sutures. Human amniotic membrane was applied for the enhancement of epithelial wound healing. 7 eyes had received subsequent penetrating keratoplasty, and had a minimum follow-up period of 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
This study showed that tectonic graft using preserved human scleral tissue for urgent purpose is useful method in acutely perforated corneal ulcer. To enhance the anatomical success of the graft, the healing of the overlying epithelium over the sclera is essential.
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