Clinical and surgical outcomes of tectonic corneal patch grafts : insights from a tertiary referral hospital

Abstract

Abstract Purpose This study aimed to report the clinical characteristics, surgical indications, outcomes and long-term complications of full-thickness or lamellar corneal patch grafts for various indications. Material-method This retrospective study included 48 eyes of 47 patients who underwent full-thickness or lamellar corneal patch keratoplasty for treatment of corneal perforation, melting and descemetocele. Patient demographics, preoperative features, best-corrected visual acuity before and after surgery, mean follow-up time, corneal graft type, long-term complications, need for additional surgery, and anatomical success were analyzed. Results Of the 48 eyes, 21 had corneal perforation, 21 had severe corneal melting, and six had descemetocele. Sjögren’s syndrome (eight eyes, 16.7%), trauma (eight eyes, 16.7%), and limbal stem cell deficiency (eight eyes, 16.7%) were the most common indications for corneal patch grafting. The most common complications after surgery were graft melting (11 eyes, 22.9%) and glaucoma (5 eyes, 10.4%). One eye developed phthisis bulbi. Penetrating keratoplasty was performed in 8 of the 11 eyes with recurrent graft melting. All descemetocele cases were central and corneal melts were more frequently located paracentrally (p = 0.0001). Anatomical success was achieved in 39 eyes (81.2%). Conclusion Corneal patch grafting is a safe and effective method for maintaining ocular integrity in corneal melting and perforation that can not be closed using conventional methods. With a success rate of over 80%, corneal patch grafts can delay a larger full-thickness graft, especially in eyes with acute inflammation, until systemic therapy is effective.

Keywords

• Corneal patch graft
• Tectonic keratoplasty
• Corneal melting
• Corneal perforation
• Descemetocele