Posters

Non-traumatic corneal perforations: therapeutic modalities in the absence of amniotic membrane

Poster Details

First Author: W. Zbiba TUNISIA

Co Author(s):    A. Baba   E. Bouayed   N. Ben Abdessalem   M. Rekik           

Abstract Details

Purpose:

The aim of our study was to retrospectively analyze predisposing conditions leading to perforation, surgical treatments and visual outcomes

Setting:

Amniotic membrane's unique combination of properties including the facilitation of migration of epithelial cells, the reinforcement of basal cellular adhesion has led to its use in the treatment of corneal perforations. Faced with the lack of amniotic membrane in our country, others surgical treatments are used

Methods:

This is a retrospective, non-comparative monocentric study of 15 patients who were admitted in our department for a nontraumatic corneal perforation between January 2014 and December 2015. Mean patient age was 60 years (range, 16-90 years) and the mean follow-up was 13.5 months (range, 6-24 months)

Results:

The predominant etiology of the corneal perforations in our series was corneal abscess, found in53.4% of cases (8 eyes), followed by dry eye in 33.4% (5 eyes) and Vernal keratoconjunctivitis found in 2 cases (13.3%). A therapeutic lens was the treatment used in 5 cases (33.4%). A conjunctival flap Was performed in 40% of cases (6 eyes) and penetrating keratoplasty was our choice in 4 cases (26.6%). Anatomical closure of the corneal perforation was achieved in 93.4%of cases (14 eyes). Final visual acuity was improved in 7 cases (46.7%). we have not noticed improvement in the remaining cases due to secondary opacities.

Conclusions:

The choice of surgical technique depends on the size of the corneal perforation, its location, its etiology and the resources available for emergencies. When amniotic membrane is unavailable, conjunctival therapeutic lens is an easy and effective technique, which is a good alternative to close corneal perforations less than 3mm. We recommend a conjunctival flap when descemetocele or perforation recurs despite previous surgical management. both techniques improve ocular surface quality and prepares the eye for later penetrating keratoplasty. The anatomical success rate is very satisfactory, but sometimes several interventions are needed to improve the visual prognosis

Financial Disclosure:

NONE