BACKGROUND The use of amniotic membranes for
corneal perforations using different surgical techniques has been widely described in the literature. This case report is a novel variation in the technique that can be useful for incorporating in clinical practice when the need arises. CASE REPORT A 36-year-old male patient presented to our clinic with a
corneal ulcer in his left eye caused by
herpetic keratitis, treated with a topical non-steroidal anti-inflammatory (
indomethacin 0.1%
solution). Examination revealed a paracentral 2-mm wide
corneal perforation on the site of the
corneal ulcer. The patient was admitted to the hospital. He was treated with intravenous
piperacillin-
ofloxacine, and an emergency surgical intervention using a lyophilized amniotic membrane was performed using a "plug and patch" technique. Postoperatively, the patient received 48 h of intravenous
antibiotics and was discharged on topical
antibiotic/
corticosteroid eyedrops along with a 10-day course of oral
antibiotics (
ofloxacin) and
antiviral therapy (
valaciclovir). Three months after surgery, the anterior chamber was formed, the corneal defect was closed, and visual acuity improved. One year after initial presentation, anterior segment optical coherence tomography showed a large scarred but healed cornea. CONCLUSIONS We report the successful use of combination of a single round-shaped rolled amniotic membrane with a multilayered amniotic membrane
transplantation for the treatment of a 2-mm-wide perforated
corneal ulcer. This technique allowed for preservation of the globe integrity without the need for a
keratoplasty, stopped further tissue loss, and was associated with a rapid visual recovery.