USING BOVINE PERICARDIUM TO PATCH A PERFORATING CORNEAL ULCER SECONDARY TO AN INFECTIOUS KERATITIS.

To describe the use of a bovine pericardial patch as an alternative to a scleral patch in the repair of a perforated corneal ulcer secondary to an infectious keratitis. We also aim to show that the bovine pericardial patch intergartes into the corneal tissue over time.

Corneal perforation presents as an ocular emergency in which urgent treatment is required to prevent infection or visual impairment. Long term the patient requires a graft but in the case of an infectious course the patient needs to recover fully before a graft is attempted. For this reason a patch is often used as a temporising measure. A patch made from bovine pericardium provides an alternative to  donor sclera from a cornea bank that is not often readily available.

A 39 year old patient presents with a perforated corneal ulcer secondary to a herpes stromal keratitis. The ulcer resulted in an iris plug and a significant corneal defect. She underwent surgery to perform a corneal patch to repair the perforated corneal ulcer. The material used for the patch was a bovine pericardium. And it was placed with 10/0 nylon sutures to fully cover the defect. By 6 weeks the bovine pericardial patch graft had started to integrate with the rest of the cornea, the anterior chamber remained formed and the Seidel test was negative. 

These results suggest that the bovine pericardial patch was a suitable solution that not only repairs the perforation but also integrates into the corneal tissue.