Perforations cornéennes non traumatiques : modalités thérapeutiques

Bouazza, M.; Bensemlali, A.; Elbelhadji, M.; Benhmidoune, L.; Kabli, H. El; Mdaghri, N. El; Abdallaoui, Maha Soussi; Zaghloul, K.; Amraoui, A.

doi:10.1016/j.jfo.2014.11.012

Cited by 15 publications

(15 citation statements)

References 24 publications

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“…ere are several known predisposing factors leading to serious stromal dissolution and disintegrity of the globe. ese include infection, Sjögren syndrome, systemic disease, sterile inflammation, Stevens-Johnson syndrome, tear-film abnormality, prior ocular surgery, collagen vascular disease, neurotrophic keratopathy, persistent epithelial defect, chemical or thermal injury of the ocular surface, and use of topical medications that contain preservatives [1][2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…If pharmacological treatments fail or are insufficient, surgery becomes the only possibility for restoring the structural integrity of the globe; it may also serve as an adjunct for another definitive treatment method. Surgical treatments for corneal perforation include tarsorrhaphy, tissue adhesives, corneal transplants, conjunctival flaps, tenon-derived patch grafts, amniotic membrane transplants (AMT), and therapeutic ptosis with botulinum toxin [1,3,7,16]. e surgical treatment of corneal perforation usually begins with a tectonic treatment to stabilise the eye.…”

Section: Introductionmentioning

confidence: 99%

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Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations

Krysik¹,

Dobrowolski

Wylęgała

et al. 2020

Journal of Ophthalmology

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Purpose. To report on surgical approaches using amniotic membrane applications and patch grafts in corneal melting and perforations. Anatomical and functional results, including advantages and disadvantages of the interventions, will also be explored. Methods. A five-year retrospective analysis of 189 surgical treatments involving corneal melting with perforation was performed. In one evaluated treatment type, a graft of amniotic membrane, often folded one to three times, was sutured with the epithelial side facing the previously mechanically debrided corneal tissue. A larger monolayer amniotic patch was then sutured, with the epithelial side facing the top of the first membrane, to the perilimbal conjunctiva. For corneal patch grafts, the size-fitting technique of graft trephination was applied, and the donor-recipient junctions were sewn with interrupted sutures. All the procedures were evaluated, noting outcomes and complications of surgery, preoperative and postoperative visual acuities, postoperative intraocular pressures, graft rejection, and other late comorbidities and complications. Results. We performed 119 amniotic membrane applications (63%) and 70 corneal patch grafts (37%). Anatomical reconstruction of the anterior chamber was achieved in 157 eyes, of which 102 eyes (86%) received an amniotic membrane and 55 eyes (79%) were treated with the patch graft technique. In 63 eyes (33%), more than one amnion or graft treatment was necessary to close the corneal perforation. Conclusions. The success of medical and surgical management depends on the cause of corneal melting, and amniotic membrane applications often require further intervention; nevertheless, patch grafts deliver better tectonic reconstruction than amniotic membrane alone.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations

Krysik¹,

Dobrowolski

Wylęgała

et al. 2020

Journal of Ophthalmology

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“…When there is no donor cornea, the amniotic membrane should be accesible or we need to use a conjunctival flap to restore ocular surface integrity temporarily or definitely [6, 9]. …”

Section: Discussionmentioning

confidence: 99%

“…Our patients who underwent surgical treatment with ALK more frequently demonstrated an improvement in visual acuity than did patients after other treatment methods (57% versus 27.6% after penetrating keratoplasty and 13.7% after corneoscleral patch graft) [18]. The size, location, and aetiology of the corneal perforation also contribute to visual acuity [4, 6]. …”

Section: Discussionmentioning

confidence: 99%

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Differences in Surgical Management of Corneal Perforations, Measured over Six Years

Krysik¹,

Dobrowolski

Lyssek-Boroń³

et al. 2017

Journal of Ophthalmology

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Purpose. To report the surgical approach, anatomical and functional results, and complications in the group of patients with corneal perforation. Materials and Methods. 247 eyes with corneal perforation were operated on between January 2010 and July 2016. The three surgical procedures, dependent on size and location of perforation, were performed: full-sized penetrating keratoplasty, corneoscleral patch graft, and anterior lamellar keratoplasty. The eyes underwent the minimum 6-month follow-up visit. Results. Between January 2010 and July 2016, 247 surgeries were performed: 116 penetrating keratoplasties, 117 corneoscleral patch grafts, and 14 anterior lamellar keratoplasties. More than one procedure was necessary in 32 eyes. Final improvement of the visual acuity, within a gain of 2 or more lines with the Snellen test, was achieved in 56 operated eyes. To achieve better final visual acuity, 75 eyes required successive surgical treatment. Complications of the surgery comprised persistent epithelial defect, glaucoma or ocular hypertension, corneal oedema, graft melting, loose corneal sutures, reinfection, anterior synechiae and fibrinoid membranes, and endophthalmitis. In 26 eyes, the treatment failure was reported. Conclusions. There is no one general-purpose surgical technique to treat corneal perforations. The complex nature of this pathology remains the individual, careful but also very distinct and multifactorial approach.

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Spontaneous corneal perforation complicating ocular rosacea: Case report

Nabih

Hamdani

Maaloum

et al. 2022

International Journal of Surgery Case Reports

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Introduction Ocular rosacea is a multifactorial disease. Its pathophysiology remains unclear. The ocular manifestations of rosacea are not specific and can range from simple blepharoconjunctivitis to sight-threatening such as corneal perforation. Case report We report the case of a 10-year-old child who presented with a red painful right eye. Based on the clinical findings, we concluded that she had a corneal perforation on ocular rosacea. She benefited from an ipsilateral lamellar autokeratoplasty by lamellar autograft. The evolution was marked by a good healing and a good visual recovery despite a corneal scar. Discussion Ocular rosacea is a multifactorial disease, with an unclear physiopathology. Corneal involvement remains the least common, but the most challenging since serious complications can occur. Corneal perforation is the most severe. Several techniques have been reported and used in the management of corneal perforations such as conjunctival flap, amniotic membrane grafting, and the use of a corneal patch. The later, corneal autografting, remains a simple and effective technique with satisfactory anatomical results. Conclusion Ocular rosacea is a pathology that is still poorly understood and of delayed diagnosis. It can lead to serious vision-threatening complications such as corneal perforation. The corneal patch is a simple, effective and efficient technique that has given good results in our case.

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Perforations cornéennes non traumatiques : modalités thérapeutiques

Cited by 15 publications

References 24 publications

Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations

Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations

Differences in Surgical Management of Corneal Perforations, Measured over Six Years

Spontaneous corneal perforation complicating ocular rosacea: Case report

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