Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetocele
Purpose: To assess the efficacy and clinical outcome of Tenon's patch graft (TPG) in corneal perforation and descemetocele. Methods: In this retrospective study, medical records of 83 patients (85 eyes) who underwent TPG for corneal perforation (58, 68%) or descemetocele (27, 32%) between July...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2022-01-01
|
| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2022;volume=70;issue=12;spage=4257;epage=4262;aulast=Kusumesh |
| _version_ | 1811177574744719360 |
|---|---|
| author | Rakhi Kusumesh Anita Ambastha Ankita Singh Divya Kumari Nilesh Mohan Bibhuti P Sinha Lalan K Arya |
| author_facet | Rakhi Kusumesh Anita Ambastha Ankita Singh Divya Kumari Nilesh Mohan Bibhuti P Sinha Lalan K Arya |
| author_sort | Rakhi Kusumesh |
| collection | DOAJ |
| description | Purpose: To assess the efficacy and clinical outcome of Tenon's patch graft (TPG) in corneal perforation and descemetocele. Methods: In this retrospective study, medical records of 83 patients (85 eyes) who underwent TPG for corneal perforation (58, 68%) or descemetocele (27, 32%) between July 2018 and October 2021 were reviewed. Clinical examination and anterior segment optical coherence tomography (AS-OCT) were performed on every follow-up visit. Anatomical success was considered as the restoration of the structural integrity with the formation of scar and anterior chamber (AC). Results: The mean size of the corneal lesions (corneal perforation or descemetocele) was 4.20 ± 1.01 mm. The mean follow-up period was 9.2 ± 5.48 months. The common underlying etiologies were infectious keratitis in 48% and autoimmune disorders in 35% of cases. TPG successfully restored the globe integrity in 74 (87%) eyes (83% in perforation and 96% in descemetocele). Anatomical failure occurred in 11 eyes (13%). The failures were due to graft dehiscence (8 eyes), graft ectasia (1 eye), and scarring with flat AC (2 eyes). The median time to epithelialization and scar formation were 3 and 15 weeks, respectively. Logistic regression analysis showed few predictors for a successful outcome: descemetoceles, noninfective causes, viral keratitis in infectious etiology, and paracentral or peripheral lesions. Conclusion: TPG can be considered an effective and inexpensive treatment for restoring the structural integrity in the eyes with perforations and descemetoceles, particularly when the donor tissue is unavailable. AS-OCT is a valuable noninvasive tool for monitoring the graft status. |
| first_indexed | 2024-04-11T06:03:40Z |
| format | Article |
| id | doaj.art-f3083f13ba004f29b8ec515d48f8d30e |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-04-11T06:03:40Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-f3083f13ba004f29b8ec515d48f8d30e2022-12-22T04:41:33ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892022-01-0170124257426210.4103/ijo.IJO_1279_22Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetoceleRakhi KusumeshAnita AmbasthaAnkita SinghDivya KumariNilesh MohanBibhuti P SinhaLalan K AryaPurpose: To assess the efficacy and clinical outcome of Tenon's patch graft (TPG) in corneal perforation and descemetocele. Methods: In this retrospective study, medical records of 83 patients (85 eyes) who underwent TPG for corneal perforation (58, 68%) or descemetocele (27, 32%) between July 2018 and October 2021 were reviewed. Clinical examination and anterior segment optical coherence tomography (AS-OCT) were performed on every follow-up visit. Anatomical success was considered as the restoration of the structural integrity with the formation of scar and anterior chamber (AC). Results: The mean size of the corneal lesions (corneal perforation or descemetocele) was 4.20 ± 1.01 mm. The mean follow-up period was 9.2 ± 5.48 months. The common underlying etiologies were infectious keratitis in 48% and autoimmune disorders in 35% of cases. TPG successfully restored the globe integrity in 74 (87%) eyes (83% in perforation and 96% in descemetocele). Anatomical failure occurred in 11 eyes (13%). The failures were due to graft dehiscence (8 eyes), graft ectasia (1 eye), and scarring with flat AC (2 eyes). The median time to epithelialization and scar formation were 3 and 15 weeks, respectively. Logistic regression analysis showed few predictors for a successful outcome: descemetoceles, noninfective causes, viral keratitis in infectious etiology, and paracentral or peripheral lesions. Conclusion: TPG can be considered an effective and inexpensive treatment for restoring the structural integrity in the eyes with perforations and descemetoceles, particularly when the donor tissue is unavailable. AS-OCT is a valuable noninvasive tool for monitoring the graft status.http://www.ijo.in/article.asp?issn=0301-4738;year=2022;volume=70;issue=12;spage=4257;epage=4262;aulast=Kusumeshcorneal perforationdescemetocelefibrin gluetenon's capsuletenon's patch graft |
| spellingShingle | Rakhi Kusumesh Anita Ambastha Ankita Singh Divya Kumari Nilesh Mohan Bibhuti P Sinha Lalan K Arya Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetocele Indian Journal of Ophthalmology corneal perforation descemetocele fibrin glue tenon's capsule tenon's patch graft |
| title | Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetocele |
| title_full | Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetocele |
| title_fullStr | Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetocele |
| title_full_unstemmed | Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetocele |
| title_short | Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetocele |
| title_sort | clinical outcome and course of tenon s patch graft in corneal perforation and descemetocele |
| topic | corneal perforation descemetocele fibrin glue tenon's capsule tenon's patch graft |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2022;volume=70;issue=12;spage=4257;epage=4262;aulast=Kusumesh |
| work_keys_str_mv | AT rakhikusumesh clinicaloutcomeandcourseoftenonspatchgraftincornealperforationanddescemetocele AT anitaambastha clinicaloutcomeandcourseoftenonspatchgraftincornealperforationanddescemetocele AT ankitasingh clinicaloutcomeandcourseoftenonspatchgraftincornealperforationanddescemetocele AT divyakumari clinicaloutcomeandcourseoftenonspatchgraftincornealperforationanddescemetocele AT nileshmohan clinicaloutcomeandcourseoftenonspatchgraftincornealperforationanddescemetocele AT bibhutipsinha clinicaloutcomeandcourseoftenonspatchgraftincornealperforationanddescemetocele AT lalankarya clinicaloutcomeandcourseoftenonspatchgraftincornealperforationanddescemetocele |