Modified tectonic keratoplasty with minimal corneal graft for corneal perforation in severe Stevens - Johnson syndrome: a case series study

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• 作者：Fuhua Wang (1)
  Suxia Li (1)
  Ting Wang (1)
  Hua Gao (1)
  Weiyun Shi (1)
  
  1. Shandong Eye Hospital ; Shandong Eye Institute ; Shandong Academy of Medical Sciences ; 372 Jingsi Road ; Jinan ; 250021 ; P.R. China
  
• 关键词：Corneal transplantation ; Corneal perforation ; Stevens ; Johnson syndrome ; Conjunctival flap
• 刊名：BMC Ophthalmology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：2,023 KB
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  25. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2415/14/97/prepub
  
• 刊物主题：Ophthalmology;
• 出版者：BioMed Central
• ISSN：1471-2415

文摘

Background Corneal perforation in severe Stevens-Johnson syndrome (SJS) presenting great therapeutic difficulties, the imperative corneal transplantation always result in graft failure and repeated recurrence of perforation. The aim of this study was to evaluate the effectiveness of a modified small tectonic keratoplasty (MSTK) with minimal corneal graft in the management of refractory corneal perforation in severe SJS. Methods Refractory corneal perforations in ten patients (10 eyes) with severe SJS were mended with a minimal corneal patch graft, under the guidance of anterior chamber optical coherence tomography, combined with conjunctival flap covering. The outcome measures included healing of the corneal perforation, survival of the corneal graft and conjunctival flap, relevant complications, and improvement in visual acuity. Results Corneal perforation healed, and global integrity was achieved in all eyes. No immune rejection or graft melting was detected. Retraction of conjunctival flap occurred in one eye, which was treated with additional procedure. Visual acuity improved in six eyes (60%), unchanged in three eyes (30%) and declined in one eye (10%). Conclusions The MSTK combined with conjunctival flap covering seems to be effective for refractory corneal perforation in severe SJS.