Document Detail

Eye preservation tectonic graft using glycerol-preserved donor cornea.
MedLine Citation:
PMID:  22975657     Owner:  NLM     Status:  MEDLINE    
AIMS: To report the surgical outcome of tectonic graft using glycerol-preserved donor corneas to treat perforated keratitis.
METHODS: The medical records were reviewed of all patients treated for perforated keratitis using glycerol-preserved corneas at a single institution between 1 July 2004 and 31 June 2010. The clinical features, precipitating factors, adjuvant therapies, and therapeutic outcomes were analyzed. Success was defined as re-epithelialization of the ocular surface without evisceration.
RESULTS: Fourteen eyes from 14 patients (6 male and 8 female) were included. Age ranged from 58 to 84 years (average, 70.71 ± 8.52 years) and the follow-up time ranged from 7 to 56 months (mean, 25.35 ± 16.84 months). The culture results showed five bacterial infections, five cases of fungal keratitis, and one mixed infection; the culture results were negative for three patients. Satisfactory anatomical integrity was obtained in eight grafts (57.14%) that healed with neovascularization. Six grafts (48.85%) showed delayed re-epithelialization and were repaired with conjunctival flaps to maintain ocular surface integrity. Three patients developed secondary glaucoma and received trans-scleral cyclophotocoagulation. Thirteen patients had satisfactory anatomical integrity without evisceration or exenteration, while one patient received evisceration at 39-month follow-up because of intractable glaucoma.
CONCLUSIONS: Glycerol-preserved donor corneas combined with anterior vitrectomy with or without conjunctival flaps may be effective substitutes for evisceration surgery in patients with perforated keratitis.
H-C Lin; S J Ong; A-N Chao
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Publication Detail:
Type:  Journal Article     Date:  2012-09-14
Journal Detail:
Title:  Eye (London, England)     Volume:  26     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-08     Completed Date:  2013-05-15     Revised Date:  2013-11-05    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  1446-50     Citation Subset:  IM    
Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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MeSH Terms
Aged, 80 and over
Anti-Bacterial Agents / therapeutic use
Conjunctiva / surgery
Corneal Perforation / microbiology,  physiopathology,  surgery*
Corneal Transplantation*
Corneal Ulcer / microbiology,  physiopathology,  surgery*
Eye Infections, Bacterial / microbiology,  physiopathology,  surgery*
Eye Infections, Fungal / microbiology,  physiopathology,  surgery*
Intravitreal Injections
Middle Aged
Organ Preservation / methods*
Surgical Flaps
Suture Techniques
Treatment Outcome
Visual Acuity / physiology
Reg. No./Substance:
0/Anti-Bacterial Agents; 56-81-5/Glycerol

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