Management of nontraumatic corneal perforation with tectonic drape patch and cyanoacrylate glue.
OBJECTIVE
To report a case of nontraumatic corneal perforation managed with a tectonic drape patch.


METHODS
Interventional case report.


RESULTS
A 60-year-old patient with a corneal scar in his left eye likely secondary to herpes simplex virus interstitial keratitis underwent laser peripheral iridotomy for narrow angles. He developed progressive thinning of the cornea overlying the scar that led to a descemetocele and then ultimately a 1.2- × 1.7-mm perforation. Intraoperatively, several attempts were made to seal the perforation with cyanoacrylate glue, but the wound continued to leak. Sterile plastic drape that was on the surgical field was fashioned into a 2-mm-diameter patch, and the peripheral edge of the tectonic drape patch was glued over the perforation, successfully sealing the cornea. One week later, the drape patch was intact without leak, and a penetrating keratoplasty was carried out without complication.


CONCLUSIONS
Tectonic drape patch technique for nontraumatic corneal perforations in which there is tissue loss is a viable temporizing option when cyanoacrylate glue alone fails and when there is no corneal tissue or amniotic membrane available to close the wound.
Khalifa
Yousuf M
YM
Department of Ophthalmology, University of California, San Francisco, CA, USA. yousuf.khalifa@hsc.utah.edu
Bailony
M Rami
MR
Bloomer
Michele M
MM
Killingsworth
Daniel
D
Jeng
Bennie H
BH
D057112:Corneal Perforation / Q000601:surgery*; D003487:Cyanoacrylates / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013526:Surgical Mesh; D014014:Tissue Adhesives / Q000008:administration & dosage*
D003487:Cyanoacrylates; D014014:Tissue Adhesives; C040229:MK 6 cyanoacrylate