Amniotic membrane plugging versus acellular porcine corneal partially penetrating deep anterior lamellar keratoplasty in the treatment of small corneal perforation.

PURPOSE: The aim of this study was to compare the effectiveness of amniotic membrane plugging (AMP) versus acellular porcine corneal stroma (APCS) partially penetrating deep anterior lamellar keratoplasty (PP-DALK) in the treatment of small corneal perforation.

METHODS

A total of 44 patients (44 eyes) with small corneal perforation (<3 mm in diameter) were retrospectively included. Among them, 24 eyes were treated with AMP (AMP group), and 20 eyes were treated with APCS-PP-DALK (APCS-PP-DALK group). The best-corrected visual acuity (BCVA), corneal transparency, ocular irritation symptoms, corneal thickness, primary disease control, postoperative complications, and survival rate were assessed.

RESULTS

Both groups showed significant postoperative improvement in BCVA versus baseline (both p < 0.001), with no difference in overall visual outcome between APCS-PP-DALK and AMP groups (p = 0.607). Corneal transparency was better in the APCS-PP-DALK group at 1, 3, and 6 months compared with the AMP group (all p < 0.05), though this difference resolved by 12 months. Corneal thickness increased significantly in both groups after surgery, with the APCS-PP-DALK group exhibiting greater thickness than the AMP group at 6 months (p < 0.001). The primary disease control rate was 85% in the APCS-PP-DALK group and 87.5% in the AMP group, yielding no statistically significant difference between the groups (p = 0.810). Furthermore, the incidence of postoperative complications was comparable between the two groups (p = 0.844).

CONCLUSION

Both AMP and APCS-PP-DALK are effective and safe treatments for small corneal perforation.