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Difficult management of corneal perforation

Poster Details

First Author: V.Lemos PORTUGAL

Co Author(s):    A. Cabugueira   A. Vicente   R. Proenca   J. Feijao   J. Branco   C. Batalha     

Abstract Details

Purpose:

Purpose: To present the surgical outcome of a resilient spontaneous small corneal perforation Introduction: Corneal perforation is an emergent condition caused by various types of infectious and noninfectious corneal disorders. Surgical and/or nonsurgical intervention is sometimes required to close the perforation, to reform the collapsed anterior chamber, and to restore visual function.

Setting:

Centro Hospitalar de Lisboa Central

Methods:

The authors present a case of a 84 year-old male patient presented with foreign body sensation in his left eye (LE). Past history included cataract, retinal detachment and Ahmed valve LE surgeries and cyclocryotherapy.

Results:

BCVA was 4/10 in right eye(RE) and light perception in the LE.Biomicroscopy revealed an anterior chamber IOL in the RE and shallow anterior chamber,central white keratopathy and small limbal perforation at 12 o’clock adjacent to an area of scleromalacia in LE.Conservative treatment with bandage contact lens was tried without success.Corneal suture was performed twice and closure of the perforation was showed only in the first postoperative day in both procedures.Consequently,he was scheduled to do crescent peripheral patch graft transplantation sutured anteriorly to the patient cornea and sclera covering the perforation. Ultrasound revealed a kissing choroid detachment that slowly resolved.

Conclusions:

There are a variety of approaches for the management of corneal perforations, from nonsurgical treatments such as bandage soft contact lenses and tissue glues, to surgical modalities such as simple cornea suturing, conjunctival flaps, multilayered amniotic membrane transplantation, and tectonic corneal grafts. The choice of the treatment depends on the size and location of the perforation and status of underlying diseases.

Financial Disclosure:

NONE

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