Posters

Patch graft with leftover tissue in perforated corneal ulcer to restore anatomy of globe in a tertiary hospital, Bangladesh

Poster Details

First Author: S.Sultana BANGLADESH

Co Author(s):    A. Salam   R. Alam   C. Sultana   S. Alam   M. Shahid   F. Jinat     

Abstract Details

Purpose:

To evaluate anatomical outcome of urgent patch graft with left over tissue in corneal perforation cases to save the eye and restore the globe integrity so that later on keratoplasty for visual function can be done when donor cornea will be available. In a developing country where most of the people are poor and rate of eye donation is not satisfactory, urgent patch graft will save the globe and maintain anatomical integrity.

Setting:

In current study, we report the clinical outcome of patch graft with leftover tissue in five perforated cases in a tertiary referral hospital, Ispahani Islamia Eye Institute and Hospital, Bangladesh. There is no finential interest in this study.

Methods:

In this study five cases of perforated corneal ulcer was taken. Microbiological test were performed immediate prior to operataon, broad spectrum antibiotic (moxifloxacin) applied topically, All patients underwent patch graft with scleral/corneal/corneo-scleral left over tissue (tissue collected after keratoplasy) at perforation site. Post operatively patients were treated with topical antibiotic, lubricants and steroid. In the result we evaluated anatomical integrity of globe and condition of the graft so that vision can be restored later by keratoplasty. Surgical procedure: All surgery done under local anaesthesia. Graft done with 10 nylon with interrupted suture. Anterior chamber formation ensured.

Results:

Among five patients three male of 30, 45, 49 years and two female of 40, 53 years. One perforation was self sealed with exudative membrane and others came with iris prolapse. All patients came to our hospital with history of keratitis for 14-21 days following trauma. No micro-organism identified on preoperative smear in all cases. After sugery two patients follow up done upto 6 months where anatomical integrity maintained and adviced for keratoplasty. Other three cases follow  up done upto 1-3 months with satisfactory anatomical integrity and graft.

Conclusions:

Our result showed that immediate patch graft with left over tissue in perforated corneal ulcer will give satisfactory outcome of anatomical integrity of globe. If we can ensure anatomical integrity in perforated cases then we can go for keratopalsty later on to restore patients visual function. As in our country rate of eye donation is very low so immediate therapeutic keratoplasty could not possible most of the cases. So it is necessary to do some alternative procedure other than keratoplasty so that we can restore anatomy of globe and later on keratoplasty could be done for regaining functional vision.

Financial Disclosure:

None