Severe Exposure Keratopathy Leading to Sterile Corneal Perforation Treated Successfully by Lamellar Corneal Patch Graft: A Case Report
We reported a case of corneal perforation due to longstanding exposure keratopathy treated successfully with lamellar corneal patch graft, conjunctival flap, and lateral tarsorrhaphy. A 75-year-old male presented with ocular pain and decreased visual acuity in his right eye since 2 weeks ago. On ext...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2022-01-01
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| Series: | Case Reports in Clinical Practice |
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| Online Access: | https://crcp.tums.ac.ir/index.php/crcp/article/view/422 |
| _version_ | 1818298989731119104 |
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| author | Iman Ansari Hamed Abbasi Amir Mohammadzadeh Kiana Hassanpour |
| author_facet | Iman Ansari Hamed Abbasi Amir Mohammadzadeh Kiana Hassanpour |
| author_sort | Iman Ansari |
| collection | DOAJ |
| description | We reported a case of corneal perforation due to longstanding exposure keratopathy treated successfully with lamellar corneal patch graft, conjunctival flap, and lateral tarsorrhaphy. A 75-year-old male presented with ocular pain and decreased visual acuity in his right eye since 2 weeks ago. On external examination, lagophthalmos in the right eye was evident. Visual acuity was hand motion on slit-lamp examination. 2×3 mm perforated area in the right cornea accompanied by adjacent corneal melting and diffuse punctate epithelial keratopathy were observed. The anterior chamber was flat. Intraoperatively, a 7×2.5 mm-diameter corneal patch graft was fashioned manually; its thickness was reduced and placed over the perforated area, successfully sealed the cornea, a partial bipedicle conjunctival flap was also applied over the graft, and lateral tarsorrhaphy was performed. Four weeks after surgery, Corrected Distance Visual Acuity (CDVA) improved to Counting Finger (CF) 20 cm. The lamellar corneal patch graft was intact without a leak, and the conjunctival flap was partially removed retracted. Corneal perforation can occur in patients with severe exposure to keratopathy, and corneal patch graft is a good option when a sizeable corneal perforation (≥3 mm diameter) is not amenable to corneal gluing. |
| first_indexed | 2024-12-13T04:44:06Z |
| format | Article |
| id | doaj.art-fb2495d431eb444dba9ef1022620bc98 |
| institution | Directory Open Access Journal |
| issn | 2538-2683 2538-2691 |
| language | English |
| last_indexed | 2024-12-13T04:44:06Z |
| publishDate | 2022-01-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Case Reports in Clinical Practice |
| spelling | doaj.art-fb2495d431eb444dba9ef1022620bc982022-12-21T23:59:13ZengTehran University of Medical SciencesCase Reports in Clinical Practice2538-26832538-26912022-01-016510.18502/crcp.v6i5.8379Severe Exposure Keratopathy Leading to Sterile Corneal Perforation Treated Successfully by Lamellar Corneal Patch Graft: A Case ReportIman Ansari0Hamed Abbasi1Amir Mohammadzadeh2Kiana Hassanpour3Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.AND Department of Ophthalmology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.We reported a case of corneal perforation due to longstanding exposure keratopathy treated successfully with lamellar corneal patch graft, conjunctival flap, and lateral tarsorrhaphy. A 75-year-old male presented with ocular pain and decreased visual acuity in his right eye since 2 weeks ago. On external examination, lagophthalmos in the right eye was evident. Visual acuity was hand motion on slit-lamp examination. 2×3 mm perforated area in the right cornea accompanied by adjacent corneal melting and diffuse punctate epithelial keratopathy were observed. The anterior chamber was flat. Intraoperatively, a 7×2.5 mm-diameter corneal patch graft was fashioned manually; its thickness was reduced and placed over the perforated area, successfully sealed the cornea, a partial bipedicle conjunctival flap was also applied over the graft, and lateral tarsorrhaphy was performed. Four weeks after surgery, Corrected Distance Visual Acuity (CDVA) improved to Counting Finger (CF) 20 cm. The lamellar corneal patch graft was intact without a leak, and the conjunctival flap was partially removed retracted. Corneal perforation can occur in patients with severe exposure to keratopathy, and corneal patch graft is a good option when a sizeable corneal perforation (≥3 mm diameter) is not amenable to corneal gluing.https://crcp.tums.ac.ir/index.php/crcp/article/view/422Exposure keratopathyCorneal perforationCorneal ulcerKeratitis |
| spellingShingle | Iman Ansari Hamed Abbasi Amir Mohammadzadeh Kiana Hassanpour Severe Exposure Keratopathy Leading to Sterile Corneal Perforation Treated Successfully by Lamellar Corneal Patch Graft: A Case Report Case Reports in Clinical Practice Exposure keratopathy Corneal perforation Corneal ulcer Keratitis |
| title | Severe Exposure Keratopathy Leading to Sterile Corneal Perforation Treated Successfully by Lamellar Corneal Patch Graft: A Case Report |
| title_full | Severe Exposure Keratopathy Leading to Sterile Corneal Perforation Treated Successfully by Lamellar Corneal Patch Graft: A Case Report |
| title_fullStr | Severe Exposure Keratopathy Leading to Sterile Corneal Perforation Treated Successfully by Lamellar Corneal Patch Graft: A Case Report |
| title_full_unstemmed | Severe Exposure Keratopathy Leading to Sterile Corneal Perforation Treated Successfully by Lamellar Corneal Patch Graft: A Case Report |
| title_short | Severe Exposure Keratopathy Leading to Sterile Corneal Perforation Treated Successfully by Lamellar Corneal Patch Graft: A Case Report |
| title_sort | severe exposure keratopathy leading to sterile corneal perforation treated successfully by lamellar corneal patch graft a case report |
| topic | Exposure keratopathy Corneal perforation Corneal ulcer Keratitis |
| url | https://crcp.tums.ac.ir/index.php/crcp/article/view/422 |
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