Fresh-tissue corneolimbal covering graft for large corneal perforation following childhood trachoma.

BACKGROUND AND

OBJECTIVE

When corneal perforation develops in patients with severe ocular surface disease and limbal stem cell deficiency following childhood trachoma infection, penetrating keratoplasty is doomed to fail. To overcome this problem, the use of a fresh-tissue corneolimbal covering graft is described.

PATIENTS AND

METHODS

Retrospective interventional case series of four patients who presented to a tertiary center from 2003 to 2005 with a large corneal perforation due to ocular surface disease. Emergency surgery consisted of suturing a fresh-tissue corneolimbal covering graft to the patients' peripheral sclera.

RESULTS

The corneolimbal graft became partially incorporated into the perforated cornea, which healed by scar tissue, after a few months. The ocular epithelial surface improved considerably. There was no recurrence of corneal perforation during the follow-up period of 1 to 3 years.

CONCLUSION

Fresh-tissue corneolimbal covering graft was found to be a useful technique for saving the integrity of the eye in cases of a large corneal perforation in patients with severe ocular surface disease, such as in childhood trachoma.