Korean J Ophthalmol.  2011 Apr;25(2):132-135. 10.3341/kjo.2011.25.2.132.

Tectonic Deep Anterior Lamellar Keratoplasty in Impending Corneal Perforation Using Cryopreserved Cornea

• Jang JH
• Chang SD

• KMID: 1111876
• DOI: http://doi.org/10.3341/kjo.2011.25.2.132

Abstract

We report a case of tectonic corneal transplantation for impending corneal perforation to preserve anatomic integrity using cryopreserved donor tissue. An 82-year-old woman exhibiting impending corneal perforation suffered from moderate ocular pain in the left eye for one week. After abnormal tissues around the impending perforation area were carefully peeled away using a Crescent blade and Vannas scissors, the patient received tectonic deep anterior lamellar keratoplasty using a cryopreserved cornea stored in Optisol GS(R) solution at -70degrees C for four weeks. At six months after surgery, the cornea remained transparent and restored the normal corneal thickness. There were no complications such as corneal haze or scars, graft rejection, recurrent corneal ulcer, and postoperative rise of intraocular pressure. Cryopreserved donor lamellar tissue is an effective substitute in emergency tectonic lamellar keratoplasty, such as impending corneal perforation and severe necrotic corneal keratitis.

Keyword

Donor corneal cryopreservation; Impending corneal perforation; Tectonic deep anterior lamellar keratoplasty

MeSH Terms

Aged, 80 and over
Cornea/injuries/*surgery
Corneal Perforation/pathology/physiopathology/*surgery
Corneal Transplantation/*methods
*Cryopreservation
Eye Injuries, Penetrating/pathology/physiopathology/*surgery
Female
Follow-Up Studies
Humans
*Tissue Donors
Visual Acuity

Figure

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  Fig. 1 Corneal ulceration with impending corneal perforation was seen by slit lamp examination before tectonic deep anterior lamellar keratoplasty.

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  Fig. 2 Postoperative photography. (A,B) A cornea transplantation was performed with cryopreserved anterior lamellar tissue and was covered with an amniotic patch. (C,D) Six months later, the cornea maintained its contour and structure.

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