Treatment of perforated cornea with an autologous lamellar scleral graft: histologic findings.

Abstract

We report a case of central corneal perforation treated with an autologous lamellar scleral graft and histologic findings obtained after a subsequent penetrating keratoplasty. A corneal perforation within a large Pseudomonas ulcer in a 55-year-old male rigid gas permeable contact lens wearer was sealed by a lamellar scleral graft from the same eye, followed by an uneventful penetrating keratoplasty 6 months later. Histology of the excised button revealed that the well-apposed graft, which maintained the irregular arrangement of the scleral collagen fibers, was embedded in the corneal stroma over the deep blood vessels and a rupture in Descemet's membrane. The clinical and histologic findings showed that autologous lamellar scleral grafts can be successfully used for the emergency treatment of corneal perforation when a corneal transplant is not available. The distinctive scleral structure revealed by histology and the inadequate graft transparency indicate that visual rehabilitation of eyes with a central corneal perforation can be achieved only by a subsequent optic penetrating keratoplasty.

• Authors: Vesna Jovanovic, Mirko Jankov, Ljubisa Nikolic
• Journal: Arquivos brasileiros de oftalmologia (Arq Bras Oftalmol) 2018 Jan-Feb Vol. 81 Issue 1 Pg. 59-62 ISSN: 1678-2925 [Electronic] Brazil
• PMID: 29538596 (Publication Type: Case Reports, Letter)

Topics

• Cornea (pathology)
• Corneal Perforation (pathology, surgery)
• Humans
• Keratoplasty, Penetrating (methods)
• Male
• Middle Aged
• Reproducibility of Results
• Sclera (pathology, transplantation)
• Transplantation, Autologous
• Treatment Outcome
• Visual Acuity