Posters

Case report: use of self-retained cryopreserved amniotic membrane in the treatment of corneal perforation

Poster Details

First Author: K.Abdelhamid MOROCCO

Co Author(s): F. El Alami   A. Mchachi   L. Benhmidoune   A. Chakib   R. Rachid   M. Elbelhadji     

Abstract Details

Purpose:

Corneal perforation can occur following various inflammatory or infectious corneal disorders. To sustain ocular integrity, an urgent and effective treatment should be applied in a rapid and effective manner to preserve the globe integrity. There are many medical and surgical treatment options for the management of this condition. Treatment options include therapeutic contact lenses, tissue glues, conjunctival flaps, amniotic membrane transplantation (AMT), keratoplasty (penetrating, lamellar), and patch graft. we report a good surgical outcome of amniotic membrane transplantation in the treatment of corneal perforation after failure of tarsorraphy and cyanoacrylate tissu glue with soft bandage contact lens (SCLs).

Setting:

Adult Ophthalmology department, Ibn Rochd University Hospital , Faculty of medicine and pharmacy, Hassan II University, Casablanca.

Methods:

Forty eight-year-old woman addressed to the emergency department of our university hospital for corneal perforation on inflammatory chronic ulcer. bacteriological and mycological samples were negative. It has already been treated by artificial tears and cicatrizants with tarsorraphy without success. She was admitted after failure of a cyanoacrylate glue with soft bandage contact lens.

Results:

Anterior segment biomicroscopy showed a superior chronic oval corneal ulcer measuring 6mm / 4mm with neovascular invasion and a 2mm perforation.The anterior chamber was flat. A multilayer amniotic membrane MA is performed using non-resorbable sutures to fixate the inlay AM layer to the cornea, a bead of AM is slipped under the inlay. A contact lens was applied and ofloxacin eye drops/ artificiel tears were administered three times a day. Six weeks later, all the nylon sutures were removed, corneal epithelialisation was complete and anterior chamber was stable. The patient is now waiting for a penetrating keratoplasty.

Conclusions:

According to our case report, Amniotic membrane transplantation AMT can be considered as a good therapeutic option for corneal perforation. Through its anti-angiogenic, anti-infectious, anti-inflammatory,  immunomodulatory and healing properties it avoids infection and the loss of the eyeball, it saves time for patients and surgeons and it allows penetrating keratoplasty to be performed at a quiet period when inflammation is suppressed.

Financial Disclosure:

None