title: [Treatment of large corneal perforations with acellular multilayer of corneal stromal lenticules harvested from femtosecond laser lenticule extraction].
abstract: OBJECTIVE
  To describe a novel surgical technique for the treatment of large corneal perforations by using acellular multilayer of corneal stromal lenticules.
  
  
  METHODS
  Prospective study. The acellular tissue used for the repair was harvested from myopic patients during the femtosecond laser (FS) refractive surgery. Informed consent, blood test and donor eligibility were obtained in each case. Three or four layers of lenticules were stacked up and stored at -80°C in pure sterile glycerin. The diameter is 6.0 to 6.5 mm and central thickness was 300 to 400 µm. If the diameter of the corneal ulcer perforation was larger than 3 mm and corneal grafts were not available, we used this kind of patches to seal the perforations. It was a retrospective case series study. Five cases of corneal ulcer perforation were enrolled in this study. One was neuropathic keratitis, one was atopic keratoconjunctivitis, and the other three were fungal keratitis. Acellular multilayer of stromal lenticules were used in these cases for emergent therapy.
  
  
  RESULTS
  The sealing of the perforation and the re-establishment of the anterior chamber were achieved successfully in all the cases. For the pericentral perforations, visual recovery was achieved. And efficient palliative management was done for the central perforations.
  
  
  CONCLUSIONS
  The reported technique seems to represent a good alternative emergency procedure for the management of large corneal perforations. It is a very useful method for Chinese hospitals where the shortage of cornea donors is a very serious problem and the amount of FS surgeries are increasing.
authors.affiliation: Department of Ophthalmology, Nanjing General Hospital of PLA, Nanjing 210002, China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Xue
authors.affiliation: Department of Ophthalmology, Nanjing General Hospital of PLA, Nanjing 210002, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Department of Ophthalmology, Nanjing General Hospital of PLA, Nanjing 210002, China.
authors.forename: Yueqin
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Nanjing General Hospital of PLA, Nanjing 210002, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Ophthalmology, Nanjing General Hospital of PLA, Nanjing 210002, China; Email: hzpjlyy@hotmail.com.
authors.forename: Zhenping
authors.initials: Z
authors.lastname: Huang
mesh_terms: D057112:Corneal Perforation / Q000209:etiology / Q000601:surgery*; D003319:Corneal Stroma / Q000637:transplantation*; D048988:Corneal Surgery, Laser; D016039:Corneal Transplantation; D003320:Corneal Ulcer / Q000150:complications; D015821:Eye Infections, Fungal / Q000150:complications; D006801:Humans; D007634:Keratitis; D009216:Myopia; D011446:Prospective Studies; D054140:Refractive Surgical Procedures; D012189:Retrospective Studies; D014945:Wound Healing