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Combined customized tectonic graft and amniotic membrane for the management of refractory corneal perforations

Poster Details

First Author: O.Shalaby EGYPT

Co Author(s):    A. El Sawaf                    

Abstract Details


To evaluate the effectiveness of customized tectonic graft (CTG) combined with amniotic membrane transplantation in cases of refractory corneal perforations.


Tanta University Ophthalmic Hospital


25 consecutive patients suffering from corneal perforations of variable size and location, were included. A tectonic graft is customized to fit the shape & size of the perforation was used to seal the perforation and secured by interrupted 10/0 nylon stitches. An overlay amniotic membrane patch graft was then applied to the corneal surface and fixed by one continuous running suture with limbal bites to ensure its fixation.


The patients were 15 females (60%) & 10 males (40%); their age ranged from 5 to 68 years. The causes of perforation were: 4 after pterygium surgery (16%), 6 immunogenic (24%), 5 neurotrophic (20%), 10 post infectious (40%). The location of the perforation was: 8 cases were central (32%), 8 paracentral (32%), & 9 were peripheral (36%). Size varied from 3mm to 7 mm in longest meridian. Corneal perforation was completely sealed, and global integrity was achieved in all cases. No rejection or graft melting was detected. The overlay amniotic patch graft was absorbed within 4 -6 weeks. Visual acuity improved in 6 cases (24%), unchanged in 14cases (56%), and declined in 5 cases (20%).


The CTG combined with overlay amniotic membrane patch graft was proved to be very effective for sealing refractory corneal perforations, and had very good functional and anatomical results.

Financial Disclosure:


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