Results of tectonic epikeratoplasty in the management of corneal perforations

Purpose: To present therapeutic application of tectonic epikeratoplasty as biological patch in severe ocular surface disorders.

Material and methods: Full thickness corneo-scleral transplants, 14 mm in diameter were used in 67 operations of 41 patients

with corneal perforation or descemetocele. (14 women and 27 men), in the period 1998-2008. The mean age of patients was

55.2 ± 17.7 years (range 15-82). The transplants were sutured over the limbus or the scleral rim and was implanted under the

conjunctiva after 360° peritomy. Donor tissue unsuitable for penetrating keratoplasty because of poor endothelium or corneal

scarring, was obtained from Lublin Eye Bank.

Results: We observed closing of the perforation in all cases. Healing of the ulceration with scar formation and new vessels ingrowth was noted. In some eyes repeated epikeratoplasties were performed.

Conclusions: Tectonic epikeratoplasty is a safe and simple method of treatment of corneal perforations. It provides a biological

patch stimulating the healing of corneal defects. It gives time for systemic treatment before further ocular surface reconstructive procedures can be performed.