Surgical management of corneal ulceration and perforation

Therapeutic deep lamellar keratoplasty for corneal perforations

“…6 If these methods fail, surgical intervention in the form of a scleral patch graft, CPG, or amniotic membrane transplantation may be performed. 1,5,7,[16][17][18] Conjunctival flaps restore ocular surface integrity, provide mechanical support, and are thought to promote healing by neutralising collagenases implicated in corneal melting. 5,7 Gundersen 19 described a technique that involved a 3601 peritomy, with coverage of the entire cornea with conjunctiva.…”

“…Short-term measures have included therapeutic soft contact lenses, tissue adhesives, epithelial transplantation, scleral patch grafts, conjunctival flaps, and amniotic membrane transplantation. [1][2][3][4][5][6][7] Although these procedures may restore the integrity of the globe, they fail to achieve a clear visual axis. Penetrating keratoplasty (PK) eliminates the scar and corneal surface abnormalities, offering a chance of visual recovery, but its success in the presence of inflammation has been variable and generally poor.…”

“…Penetrating keratoplasty (PK) eliminates the scar and corneal surface abnormalities, offering a chance of visual recovery, but its success in the presence of inflammation has been variable and generally poor. 1,8,9 Penetrating keratoplasties performed in the acute setting of corneal perforation are more likely to fail. 9 Deep lamellar keratoplasty (DLK) involves dissection of the host's corneal stroma down to the level of Descemet's membrane.…”

Management of inflammatory corneal melt leading to central perforation in children: a retrospective study and review of literature

“…Although the literature has reports about management of bacterial and fungal keratitis in mixed cohorts of adults and children, 2,[14][15][16][17][18] especially in developing countries, there is little about the management of protozoal or viral keratitis and even less about non-infectious keratitis leading to perforation in children.…”

Superior forniceal conjunctival advancement pedicles (SFCAP) in the management of acute and impending corneal perforations

“…The ulcers may progress rapidly and may result in corneal perforations that lead to devastating visual sequelae. [1][2][3] Restoration of the integrity of the globe and ocular tension is necessary to preserve the visual potential. Surgical options to manage nontraumatic corneal perforations include emergency tectonic corneal grafts, tissue gluing, and patching with exogenous material such as preserved pericardium, dura matter, autologous cartilage, and fascia.…”