Anitha Venugopal, Ravindran Meenakshi, Ghorpade Aditya
Cornea, Anterior Segment, Refractive and Femto Surgeon, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Tirunelveli, Tamilnadu, India.
Paediatric and Strabismus Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Tirunelveli, Tamilnadu, India.
Am J Ophthalmol Case Rep. 2022 Mar;25:101322. doi: 10.1016/j.ajoc.2022.101322. Epub 2022 Jan 24.
Covid-19 has profoundly affected the day-to-day lives of individual citizens. It has strained all aspects of health care including eye banking and corneal transplantation. Although elective procedures like optical Keratoplasty can be postponed, management of perforating ulcers needs tectonic Keratoplasty to avoid permanent ocular morbidities. It has become inevitable for corneal surgeons to innovate newer methods of treatment for such corneal diseases. The large corneal perforations if left untreated may lead to permanent visual loss. An alternative method of managing a large peripheral corneal perforation of size 5 × 5.5 mm was done using Tenons patch graft with Gore-tex in a 50-year-old female patient, during the lockdown.
Tenons graft with Gore-tex, effectively sealed the large corneal perforation in our case without iris incarceration, favourable for future visual rehabilitation.
Tenons and Gore-tex are readily available. It is not necessary to rely on the donor corneas or the distributing eye banks during this pandemic situation. In the future, this procedure can reduce the burden of the pre-existing increase in the gap between the need and supply of donor corneas in developing countries.
新冠疫情对公民的日常生活产生了深远影响。它给包括眼库和角膜移植在内的医疗保健各个方面都带来了压力。尽管像光学角膜移植这样的择期手术可以推迟,但穿孔性溃疡的治疗需要进行结构性角膜移植以避免永久性眼部疾病。角膜外科医生创新此类角膜疾病的新治疗方法已成为必然。大的角膜穿孔若不治疗可能导致永久性视力丧失。在封锁期间,对一名50岁女性患者采用带戈尔特斯(Gore-tex)的眼球筋膜贴片移植术治疗了一处5×5.5毫米的大周边角膜穿孔。
在我们的病例中,带戈尔特斯的眼球筋膜移植有效地封闭了大的角膜穿孔,且无虹膜嵌顿,有利于未来的视力康复。
眼球筋膜和戈尔特斯很容易获得。在这种大流行情况下,无需依赖供体角膜或分发眼库。未来,该手术可以减轻发展中国家供体角膜供需差距预先存在的增加所带来的负担。