Abstract
Abstract: :
Purposes: To describe a new micrsurgical technique of full thickness autologous tarsal graft (FTATG) for the treatment of central corneal defect with uveal prolapse as temporary solution for closing the eye while awaiting penetrating keratoplasty (PKP). Methods: An adult female was evaluated for corneal perforation ( 3.0 x 4.0 mm) with iris prolapse, flat anterior chamber caused by bacterial keratitis. Patient previously failed Gundersen flap and conjuctival bridge flap and was referred for enucleation. Patient underwent FTATG (upper eyelid, same eye , size 3.5 x 5.0 mm) surgery under general anesthesia at the Eye Clinic of Sarajevo, Bosnia and Herzegovina. Presented are the operative technique and postoperative results after FTATG and subsequent PKP. Results: FTATG survived supported with conjuctival bridge flap and temporary tarsorraphy. Four months after repair eye had no signs of active inflammation. Peripheral cornea was clear with central corneal opacification with superficial vascularization. VA RE : 20/100. IOP RE: 18.5 mmHg. PKP was performed and corneal reaction developed one month after PKP. After intensive immunosupression visual acuity improved to 20/40 with clear graft. Conclusion: During the war. Sarajevo was under siege, the possibilities for treatment of corneal perforation were extremely limited. Autotransplantation of full thickness tarsal graft was the only solution to protect eye while awaiting a PKP and avoid enucleation. In war time or in special circumstances when patching of full thickness corneal defect ( of moderate size ) is needed a similar procedure can be performed.
Keywords: transplantation • keratitis • eyelid