title: [Non-traumatic corneal perforations: Therapeutic modalities].
abstract: BACKGROUND
  The treatment of non-traumatic perforations of the cornea is a real challenge for the choice of surgical technique as well as for management of the causal pathology. The goal of our study is to determine the anatomical and functional results of the management of non-traumatic perforation of the cornea in the absence of ready access to a corneal graft.
  
  
  METHODS
  This is a retrospective, non-comparative monocentric study of 23 consecutive cases diagnosed and treated between January 2011 and January 2013. We included 23 eyes with non-traumatic corneal perforation. Various surgical techniques were used depending on the size and location of the corneal perforation.
  
  
  RESULTS
  The predominant etiology of the corneal perforations in our series was corneal abscess, found in 30.4% of cases (7 eyes). A conjunctival flap was performed in 43.5% of cases (10 eyes) followed by tarsorrhaphy in 21.7% of cases (5 eyes), autologous corneal patch in 17.4% of cases (4 eyes), amniotic membrane in 13% of cases (3 eyes) and finally cyanoacrylate glue in one case. Mean follow-up was 12.4 ± 2.1 months. Anatomical closure of the corneal perforation was achieved in 91.3% of cases (21 eyes), while the final visual acuity was not improved due to secondary opacities.
  
  
  CONCLUSIONS
  The choice of surgical technique depends on the size of the corneal perforation, its location, its etiology and the resources available for emergencies. When amniotic membrane and corneal donor tissue are unavailable, conjunctival flap is an easy and effective technique, which is a good alternative to close corneal perforations less than 3mm. It improves ocular surface quality and prepares the eye for later penetrating keratoplasty.
  
  
  CONCLUSIONS
  Conjunctival flap is a good technique that is still relevant today, especially in the absence of corneal donor tissue or amniotic membrane. The anatomical success rate is very satisfactory, but sometimes several interventions are needed to improve the visual prognosis.
authors.affiliation: Service d'ophtalmologie adulte, hôpital 20-Août-1953, quartier des hôpitaux, Casablanca, Maroc. Electronic address: mbouazza83@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Bouazza
authors.affiliation: Service d'ophtalmologie adulte, hôpital 20-Août-1953, quartier des hôpitaux, Casablanca, Maroc.
authors.forename: A
authors.initials: A
authors.lastname: Amine Bensemlali
authors.affiliation: Service d'ophtalmologie adulte, hôpital 20-Août-1953, quartier des hôpitaux, Casablanca, Maroc.
authors.forename: M
authors.initials: M
authors.lastname: Elbelhadji
authors.affiliation: Service d'ophtalmologie adulte, hôpital 20-Août-1953, quartier des hôpitaux, Casablanca, Maroc.
authors.forename: L
authors.initials: L
authors.lastname: Benhmidoune
authors.affiliation: Service de médecine interne, CHU Ibn Rochd, quartier des hôpitaux, 1, rue des Hôpitaux, Casablanca, Maroc.
authors.forename: H
authors.initials: H
authors.lastname: El Kabli
authors.affiliation: Service de microbiologie, CHU Ibn Rochd, quartier des hôpitaux, 1, rue des Hôpitaux, Casablanca, Maroc.
authors.forename: N
authors.initials: N
authors.lastname: El M'daghri
authors.affiliation: Service de parasitologie et de mycologie, CHU Ibn Rochd, quartier des hôpitaux, 1, rue des Hôpitaux, Casablanca, Maroc.
authors.forename: M
authors.initials: M
authors.lastname: Soussi Abdallaoui
authors.affiliation: Service d'ophtalmologie pédiatrique, hôpital 20-Août-1953, quartier des hôpitaux, Casablanca, Maroc.
authors.forename: K
authors.initials: K
authors.lastname: Zaghloul
authors.affiliation: Service d'ophtalmologie adulte, hôpital 20-Août-1953, quartier des hôpitaux, Casablanca, Maroc.
authors.forename: A
authors.initials: A
authors.lastname: Amraoui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057112:Corneal Perforation / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D055815:Young Adult
keywords: Abcès de cornée; Autologous corneal patch; Conjunctival flap; Corneal abscess; Corneal perforation; Non traumatique; Non-traumatic; Patch cornéen autologue; Perforation cornéenne; Recouvrement conjonctival