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Penetrating Keratoplasty for Perforated Corneal Ulcers
- Source :
- Cornea. 25:44-46
- Publication Year :
- 2006
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2006.
-
Abstract
- PURPOSE This study was designed to study an alternative technique of lamellar separation of corneal layers for therapeutic keratoplasty in place of an en bloc removal of host corneal button in eyes with perforated corneal ulcers with pseudocornea. METHODS Twelve eyes with perforated corneal ulcers with pseudocornea in which therapeutic keratoplasty was planned were included in the study. A new technique was used in which the host corneal tissue was removed in layers by lamellar dissection started peripherally and proceeding centripetally with care taken to prevent perforation at the site of iris incarceration. After injection of viscoelastic into the anterior chamber with a 26-gauge needle entered tangentially, the deeper layer of the cornea was then gently dissected and peeled away from the iris tissue, with care not to avulse the fragile iris and the overlying fibrotic membrane. Adjunctive procedures were performed, and the donor tissue was secured over the host bed. RESULTS A complete separation of the iris tissue from corneal button and the fibrous membrane was achieved in 9 eyes. In 3 eyes, iris was partly trimmed along with the fibrous membrane, because the membrane was totally adherent to the iris tissue. Eight patients required pupilloplasty. Apart from minimal bleeding, no other complication was encountered. At the end of 3 months, 9 of 12 grafts remained clear. CONCLUSIONS Debulking and layer-by-layer removal of host corneal tissue is effective in preservation of iris while performing therapeutic keratoplasty in eyes with perforated corneal ulcers with pseudocornea.
- Subjects :
- Adult
Male
medicine.medical_specialty
genetic structures
Fibrous membrane
Perforation (oil well)
Visual Acuity
Eye Infections, Viral
Dissection (medical)
Eye Infections, Bacterial
Cornea
Corneal edema
Humans
Medicine
Iris (anatomy)
Corneal Ulcer
Aged
Rupture, Spontaneous
business.industry
Pupilloplasty
Middle Aged
medicine.disease
Debulking
eye diseases
Surgery
Ophthalmology
medicine.anatomical_structure
Female
sense organs
business
Keratoplasty, Penetrating
Subjects
Details
- ISSN :
- 02773740
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Cornea
- Accession number :
- edsair.doi.dedup.....06c9389366db47a9e1398971bab3f2e3