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Published on: July 6, 2015
Tenons Patch Graft in the Management of Large Corneal Perforations
Sanita Korah1, Satheesh S T Selvin, Zia S Pradhan
1*Department of Ophthalmology, Christian Medical College and Hospital, Vellore, India; and†Narayana Nethralaya, Bangalore, India.
Purpose:
To describe a technique to manage corneal perforations between 3 and 6 mm in size using autologous Tenons tissue with cyanoacrylate glue and a bandage contact lens.
Methods:
A thin layer of Tenons capsule harvested from the patient's own eye is used to seal the perforation and act as a scaffold. The Tenons patch graft is spread over the perforation and held in place by the application of cyanoacrylate glue. A bandage contact lens is then placed on the eye.
Results:
A 6-year retrospective review of 28 patients who underwent this procedure was performed. One patient was lost to follow-up. Of the 27 patients who were followed up, 20 healed completely, with an adherent leucoma and preservation of the anterior chamber. The condition of one patient (with a perforated Pseudomonas corneal ulcer) progressively worsened despite maximum medical therapy and had to undergo evisceration.
Conclusions:
This procedure makes use of easily available autologous Tenons tissue in patients with corneal perforations too large to be managed with cyanoacrylate glue alone, to preserve eyeball morphology. A corneal transplant can then be done when the cornea has healed.
