Chronic corneal perforations

We report the etiological profile and management with simple patch, tarsorrhaphies, conjunctival flaps, tissue adhesive, or penetrating keratoplasty of 104 chronic corneal perforations in a North India population. Chronic corneal perforations were observed in infective keratitis, degenerative keratolysis, neurotrophic keratitis, chemical burns, dry eyes, collagen vascular diseases, and following cataract extraction. A two-stage tissue adhesive application and adhesive-assisted debridement of epithelial lining at the cornea surface of perforation were important factors in healing. Although penetrating keratoplasties brought comparable anatomical and functional success in these cases, in developing countries, where facilities for keratoplasty and availability of corneal donor is poor, detection and management of small perforations in diseased cornea with tissue adhesive is recommended.