Dataset Information

Pericardium Patch Graft for Severe Corneal Wound Burn

ABSTRACT:

Purpose:

To report a novel management technique using pericardial patch graft for severe corneal wound burn following phacoemulsification of dense cataract with shallow anterior chamber (AC) and overfilled AC with viscoelastic.

Methods:

Case report.

Results:

A 46-year-old patient with a shallow AC and dense cataract, who underwent phacoemulsification using “soft shell” technique had severe wound burn which was refractory to conventional management with corneal suturing and placing bandage contact lens. He underwent Tutoplast® (Innovative Ophthalmic Products, Inc., Costa Mesa, CA, USA) pericardium patch graft, which fully resorbed and resolved the wound leak over 6 weeks, leaving a well-healed corneal wound.

Conclusion:

Pericardium patch graft is a safe and effective technique to manage extensive phaco wound burn which is refractory to conventional management options.

SUBMITTER: Ashena Z

PROVIDER: S-EPMC8579793 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceExposure of the tube of an aqueous drainage device (ADD) through the conjunctiva is a serious complication of ADD surgery. Although placement of gamma-irradiated sterile cornea (GISC) as a patch graft over the tube is commonly performed, exposures still occur.ObjectivesTo measure GISC patch graft thickness as a function of time after surgery, estimate the rate of graft thinning, and determine risk factors for graft thinning.Design, setting, and participantsCross-sectional study of graft thickness using anterior segment optic coherence tomography (AS-OCT) was conducted at the Wilmer Eye Institute at Johns Hopkins Hospital. A total of 107 patients (120 eyes, 120 ADDs) 18 years or older who underwent ADD surgery at Johns Hopkins with GISC patch graft between July 1, 2010, and October 31, 2016, were enrolled.InterventionImplantation of ADD with placement of GISC patch graft over the tube.Main outcomes and measuresGraft thickness vs time after ADD surgery and risk factors for undetectable graft.ResultsOf the 107 patients included in the analysis, the mean (SD) age of the cohort was 64 (16.2) years, 49 (45.8%) were male, and 43 (40.2%) were African American. The mean time of measurement after surgery was 1.7 years (range, 1 day to 6 years). Thinner grafts were observed as the time after surgery lengthened (??regression coefficient, -60 µm per year since surgery; 95% CI, -80 µm to -40 µm). The odds ratio of undetectable grafts per year after ADD surgery was 2.1 (95% CI, 1.5-3.0; P?<?.001). Age, sex, race, type of ADD, quadrant of ADD placement, diagnosis of uveitis or dry eye, and prior conjunctival surgery were not correlated with the presence or absence of the graft.Conclusions and relevanceGamma-irradiated sterile corneal patch grafts do not always retain their integrity after ADD surgery. Data from this cross-sectional study showed that on average, the longer the time after surgery, the thinner the graft. These findings suggest that placement of a GISC patch graft is no guarantee against tube exposure, and that better strategies are needed for preventing this complication.