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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

Purpose:

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

Setting:

Tanta University Ophthalmic Hospital

Methods:

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.

Results:

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%).

Conclusions:

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:

NONE

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