[Tenon-plasty and early keratoplasty in severe chemical eye burns]

In severe eye burns with destruction of extensive areas of the conjunctiva and epibulbar tissue, Tenon plasty has proved to be successful. Because the epithelium fails to cover the denuded stroma, the corneal surface must be protected by an artificial epithelium. If necrolysis occurs, a tectonic keratoplasty must be performed early. The clinical courses of 12 patients with 14 very severely burned eyes are reported. In addition to Tenon plasty, early penetrating keratoplasies with large diameters 10-16 mm were performed up to 3 months after the accident. The follow-up time was between 6 and 34 months (mean 15.1 months). In five cases the Tenon tissue showed marked inflammation, and the keratoplasties developed large, persistent epithelial defects and had to be covered by conjunctiva. In the other cases it was possible to preserve a healthy epithelial layer by applying soft contact lenses. In 79% of the cases an endothelial graft rejection was observed. In about 50% the transplants were lost. Early keratoplasties are mainly for tectonic repair in severely burned eyes. Optical rehabilitation was achieved in only a few cases.