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The conundrum of post-traumatic corneal rupture in a patient with Ehlers-Danlos syndrome
Parul Jain1, Isha Gupta2, Avani Hariani2
1Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India.
Insights
This case study details managing a corneal tear in a child with Ehlers-Danlos Syndrome (EDS). Cyanoacrylate glue successfully sealed an intraoperative corneal rupture, offering a potential solution for fragile eye tissues.
Area of Science:
- Ophthalmology
- Genetics
- Tissue Engineering
Background:
- Ehlers-Danlos Syndrome (EDS) is a group of inherited connective tissue disorders.
- Corneal fragility and complications like Descemet's membrane detachment are potential risks in EDS patients.
- Management of traumatic eye injuries in pediatric EDS cases presents unique challenges.
Observation:
- A 7-year-old child with known Ehlers-Danlos Syndrome (EDS) presented with a post-traumatic Descemet's membrane detachment in the right eye.
- Descemetopexy using intracameral sulfur hexafluoride (SF6) gas was performed for the detachment.
- An unexpected spontaneous intraoperative corneal rupture occurred during the descemetopexy procedure.
Findings:
- The intraoperative corneal rupture was successfully managed using cyanoacrylate tissue adhesive glue.
- A bandage contact lens was applied post-operatively.
- This approach highlights the efficacy of cyanoacrylate glue in managing corneal defects in patients with compromised tissue integrity.
Implications:
- Cyanoacrylate tissue adhesive glue can be a viable treatment option for corneal ruptures in patients with Ehlers-Danlos Syndrome.
- This method offers an alternative to traditional suturing when tissue strength is insufficient.
- Further research into tissue adhesives for ocular trauma in connective tissue disorders is warranted.
Abstract:
To describe the management of post-traumatic Descemet's membrane detachment and intraoperative corneal rupture in a known case of Ehlers-Danlos Syndrome (EDS). A 7-year-old child, a known case of EDS, presented with Descemet's membrane tear in the right eye for which intracameral sulfur hexafluoride (SF6) and descemetopexy were done. Intraoperative spontaneous rupture of the cornea was noted during descemetopexy which was managed using cyanoacrylate glue and bandage contact lens. We successfully used cyanoacrylate tissue adhesive glue for sealing of corneal rupture suggesting that it can be considered a treatment option for such cases where there is a lack of tissue strength for suturing.
