title: Tectonic grafts for corneal thinning and perforations.
abstract: OBJECTIVE
  To evaluate the success of tectonic grafts in cases of corneal thinning and perforations.
  
  
  METHODS
  We performed 42 tectonic grafts in 41 eyes of 40 patients. Three types of tectonic grafts were used in our treatment protocol. These were (a) full-thickness grafts, (b) mushroom grafts, and (c) lamellar grafts. The parameters evaluated were indications, visual acuity, location, size and type of graft, postoperative outcome, and complications, if any.
  
  
  RESULTS
  The most common indication for tectonic grafts was corneal thinning and perforation subsequent to infection (12 eyes) followed by those due to immunologic causes (six eyes) and trauma (six eyes). Twenty-four full-thickness tectonic grafts, nine mushroom grafts, and nine lamellar patch grafts were performed. Anatomical success was achieved in 35 of 41 (85.4%) eyes. Visual acuity of 6/24 or better was obtained in 29 of 41 (70.73%) eyes. The mean of best-corrected visual acuity (expressed in decimal) improved from 0.2 +/- 0.26 to 0.34 +/- 0.26 at an average follow-up of 10.83 +/- 6.27 months. The major complications were peripheral anterior synechiae in four eyes (9.76%) and graft melting in five eyes (12.2%).
  
  
  CONCLUSIONS
  Tectonic graft is a useful therapeutic option in selected cases of corneal thinning and perforations because it effectively restores the integrity of the eye and allows acceptable visual rehabilitation.
authors.affiliation: Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: M
authors.initials: M
authors.lastname: Vanathi
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.forename: Jeewan S
authors.initials: JS
authors.lastname: Titiyal
authors.forename: Radhika
authors.initials: R
authors.lastname: Tandon
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome; D014792:Visual Acuity