Use of human fibrin glue and amniotic membrane transplant in corneal perforation.
OBJECTIVE
To repair corneal perforation using human fibrin glue (HFG) and amniotic membrane transplant (AMT).


METHODS
Three patients in whom central corneal perforations, approximately 2 mm in diameter, occurred after ocular or systemic disease were successfully cured using HFG and AMT. The technique consists first of using a high-viscosity sodium hyaluronate viscoelastic material to restore anterior chamber depth followed by a debridement of the ulcer. The perforation site is filled with the HFG to corneal surface level. The so-formed plug is then secured with an AMT to avoid its extrusion. An extended-wear bandage contact lens and topical antibiotics were used in these patients for 3 weeks.


RESULTS
Total reepithelialization was observed after an average of 15 postoperative days. The AMT dissolved within 8 weeks to uncover a whitish scar formed within the perforation sites. No complications were observed in any patients. After a follow-up period of 195-325 days, all corneas remained stable; there was no infection or ulcer recurrence, but some corneal scar thinning was observed in all three cases.


CONCLUSIONS
The described surgical approach using HFG and AMT allowed a successful repair of corneal perforations with a diameter of 2 mm associated with significant loss of stroma. This method may be a good alternative to delay penetrating keratoplasty for treating corneal perforations, especially in acute cases in which graft rejection risk is high. eal
Department of Ophthalmology, CHU Sart-Tilman, University of Liège, Belgium. bduchesne@chu.ulg.ac.be
B
B
Duchesne
H
H
Tahi
A
A
Galand
D000368:Aged; D000369:Aged, 80 and over; D000650:Amnion / Q000637:transplantation*; D003131:Combined Modality Therapy; D003315:Cornea / Q000187:drug effects; D003316:Corneal Diseases / Q000628:therapy*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D012422:Rupture, Spontaneous; D014014:Tissue Adhesives / Q000627:therapeutic use*
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives