Outcomes of a Tenon Patch Graft for Corneal Perforations in Resolving Infectious Keratitis

To report the outcomes of a Tenon patch graft (TPG) in sealing corneal perforations in cases with resolving infectious keratitis.

This retrospective interventional study was conducted at a tertiary eye care center. All patients who underwent a TPG for corneal perforations because of clinically or/and microbiologically diagnosed infectious keratitis between 2021 and 2023 were included. The surgical technique was consistent with that used in noninfective etiology. Out of 100 cases undergoing a TPG during the same period, 15 eyes of 14 patients had corneal perforations secondary to infectious keratitis.

The etiological profile included bacterial keratitis in 8, viral and fungal keratitis in 3, and Pythium keratitis in 1 eye of 15 eyes. One patient had bilateral infectious keratitis after refractive surgery. The perforations were central in 7 and paracentral in 8 eyes. Successful restoration of tectonic integrity at 1 month was achieved in 14/15 eyes (93%). One patient had a repeat perforation at 3 weeks postoperatively, which was managed with a cyanoacrylate glue application. Infection control was achieved in all cases with adjunctive topical antimicrobial therapy.

A TPG is a viable option for restoring globe integrity in corneal perforations encountered in resolving infectious keratitis.