title: Eye preservation tectonic graft using glycerol-preserved donor cornea.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. hclinn@adm.cgmh.org.tw
authors.forename: H-C
authors.initials: HC
authors.lastname: Lin
authors.forename: S J
authors.initials: SJ
authors.lastname: Ong
authors.forename: A-N
authors.initials: AN
authors.lastname: Chao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003228:Conjunctiva / Q000601:surgery; D003315:Cornea; D057112:Corneal Perforation / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D016039:Corneal Transplantation; D003320:Corneal Ulcer / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D015821:Eye Infections, Fungal / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005990:Glycerol; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D000900:Anti-Bacterial Agents; D005990:Glycerol