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Non-traumatic corneal perforations: aetiology, treatment and outcomes
  1. Denise Loya-Garcia1,
  2. Juan Carlos Serna-Ojeda1,
  3. Lucero Pedro-Aguilar1,
  4. Aida Jimenez-Corona2,3,
  5. Andrew Olivo-Payne1,
  6. Enrique O Graue-Hernandez1
  1. 1Department of Cornea and Refractive Surgery, Instituto de Oftalmología “Conde de Valenciana”, Mexico City, Mexico
  2. 2Department of Ocular Epidemiology and Visual Health, Instituto de Oftalmología “Conde de Valenciana”, Mexico City, Mexico
  3. 3General Directorate of Epidemiology, Health Secretariat, Mexico City, Mexico
  1. Correspondence to Dr Enrique O Graue-Hernández, Department of Cornea and Refractive Surgery, Instituto de Oftalmología “Conde de Valenciana”, Chimalpopoca 14, Cuauhtémoc, Mexico City 06800, Mexico; egraueh{at}gmail.com

Abstract

Purpose To report aetiology, characteristics, treatment and main outcomes of non-traumatic corneal perforations in a single referral centre.

Methods A retrospective review of clinical records of patients diagnosed with non-traumatic corneal perforation. The analysed data included demographic characteristics, medical history, initial and final corrected distance visual acuity (CDVA), perforation aetiology, size, location, initial therapy, surgical treatment, ocular integrity and complications. A comparison between non-infectious and infectious groups was performed. Different variables were analysed through a multiple logistic regression analysis for the probability to have at least one more procedure.

Results We included 127 eyes of 116 patients with a mean age of 50 years and a mean follow-up of 11 months. The initial CDVA was 3.00 logarithm of the minimum angle of resolution (logMAR) and the final CDVA was 2.30 logMAR (p>0.5). Regarding treatment, of the 49 eyes with an initial cyanoacrylate patch, 35 eyes (71.4%) had at least one more procedure performed (p>0.001). In comparison, of the 49 eyes with an initial tectonic penetrating keratoplasty (PK), 33 (67.3%) eyes remained stable while 16 (32.7%) eyes needed one or more interventions (p=0.004). In a multiple logistic regression analysis, an initial cyanoacrylate patch represented a probability of 4.7 times to require a subsequent procedure in comparison with an initial PK. Overall, globe integrity was achieved in 96.1% of the cases.

Conclusions Corneal perforations represent an important cause of ocular morbidity. The use of a cyanoacrylate patch is useful as an initial therapy in corneal perforations; however, procedures such as PK are often necessary to achieve anatomical success, especially in non-infectious aetiologies.

  • Cornea
  • Infection
  • Inflammation
  • Treatment Surgery
  • Treatment Medical

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