Intralamellar autopatch with lamellar keratoplasty for paracentral corneal perforations.
OBJECTIVE
To report a new technique of tectonic intralamellar autopatch with lamellar keratoplasty (LK) for paracentral corneal perforations.


METHODS
A partial thickness lamellar dissection of the host was undertaken to remove the superficial epithelium and the anterior stroma. A second lamellar dissection began at the periphery to approximately 1 mm away from the perforation to fashion a hinge. The hinged autolamellar flap was reflected over the perforation and sutured to the host with interrupted sutures. Finally, the autolamellar patch graft was supported by a lamellar graft, which was secured in place with 16 interrupted sutures. This technique was undertaken in 4 eyes with paracentral perforation after trauma (2 eyes), after pterygium (1 eye), and inadvertent perforation during host bed dissection of large LK (1 eye).


RESULTS
All eyes achieved a stable ocular surface and a postoperative visual acuity of more than 6/60.


CONCLUSIONS
Intralamellar autopatch with lamellar keratoplasty provides adequate tectonic support in cases of paracentral corneal perforation and thereby maintaining the integrity of the globe. It also provides ambulatory visual acuity.
Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Jeewan S
JS
Titiyal
Manotosh
M
Ray
Namrata
N
Sharma
Rajesh
R
Sinha
Rasik B
RB
Vajpayee
D000328:Adult; D065306:Corneal Injuries; D019781:Corneal Topography; D015807:Eye Injuries, Penetrating / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013537:Sutures; D014792:Visual Acuity