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Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetocele
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Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetocele
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Journal Article
Clinical outcome and course of Tenon's patch graft in corneal perforation and descemetocele
2022
Overview
To assess the efficacy and clinical outcome of Tenon's patch graft (TPG) in corneal perforation and descemetocele. 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). 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. 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.
Publisher
Medknow Publications and Media Pvt. Ltd
Subject
