Dealing With Pericylindrical Melts in Keratoprosthesis: Tenon Patch Graft to the Rescue

Area of Science:

• Ophthalmology
• Corneal Surgery
• Prosthetic Eye Implants

Background:

• Corneal melt is a severe complication following keratoprosthesis (KPro) implantation, potentially leading to vision loss and globe loss.
• Sterile pericylindrical corneal melt presents a significant challenge in managing patients with Auro keratoprosthesis.

Purpose of the Study:

• To evaluate the outcomes of autologous Tenon patch grafts in managing sterile pericylindrical corneal melt in patients with Auro keratoprosthesis.
• To assess the efficacy and safety of this surgical technique in preserving ocular integrity.

Main Methods:

• A retrospective case series of three patients with Auro keratoprosthesis who developed sterile pericylindrical corneal melt.
• Surgical technique involved freshening melt edges, harvesting an autologous Tenon graft, and securing it with fibrin glue and/or sutures, followed by a bandage contact lens.

Main Results:

• Autologous Tenon patch grafts demonstrated successful integration in all three patients.
• Mean epithelial healing time was one month, with preserved globe integrity and no major postoperative complications.
• Mean follow-up was 12 months (range 6-18 months), indicating sustained positive outcomes.

Conclusions:

• Autologous Tenon patch grafting is a simple, innovative, and effective surgical option for managing corneal melt associated with keratoprosthesis.
• This technique offers a promising approach to prevent severe complications and preserve visual prognosis and globe integrity.