Tectonic Lamellar Keratoplasty Using Cryopreserved Cornea in a Large Descemetocele

We describe herein a case of an impending corneal perforation with a large descemetocele in a patient with previous penetrating keratoplasty (PKP) that subsequently was treated with an emergent lamellar keratoplasty using frozen preserved cornea. A 76-year-old male patient, who had a PKP, presented with a completely whitish and edematous graft accompanied by large epithelial defects. Although antibiotics and antiviral agents were tried for three days, the corneal stroma abruptly melted, except for the Descemet's membrane and endothelium. Cryopreserved corneal tissue that was kept at -80degrees C was thawed and sutured on top of the remaining Descemet's membrane and endothelium. Pathological and microbiological tests were conducted using the remaining donor and recipient corneal tissues. After tectonic corneal transplantation on top of a large descemetocele, a healthy graft and relatively clear interfaces between graft-host junctions were maintained without serious adverse reactions throughout 6 month follow-up period. Microbiological evaluations of donor tissue at the time of thawing and tissue preparation were done, and the results were all negative. Tissue that was taken intraoperatively from the recipient cornea also showed negative microbiological results. In conclusion, tectonic lamellar keratoplasty, using cryopreserved corneal tissue, only onto the remaining Descemet's membrane and endothelium in an emergent condition, was a safe and effective treatment.

Tectonic Deep Anterior Lamellar Keratoplasty in Impending Corneal Perforation Using Cryopreserved Cornea

We report a case of tectonic corneal transplantation for impending corneal perforation to preserve anatomic integrity using cryopreserved donor tissue. An 82-year-old woman exhibiting impending corneal perforation suffered from moderate ocular pain in the left eye for one week. After abnormal tissues around the impending perforation area were carefully peeled away using a Crescent blade and Vannas scissors, the patient received tectonic deep anterior lamellar keratoplasty using a cryopreserved cornea stored in Optisol GS(R) solution at -70degrees C for four weeks. At six months after surgery, the cornea remained transparent and restored the normal corneal thickness. There were no complications such as corneal haze or scars, graft rejection, recurrent corneal ulcer, and postoperative rise of intraocular pressure. Cryopreserved donor lamellar tissue is an effective substitute in emergency tectonic lamellar keratoplasty, such as impending corneal perforation and severe necrotic corneal keratitis.

A retrospective analysis of open globe injuries in a tertiary ophthalmological centre in North-East India.

PURPOSE: To evaluate the clinical presentations and surgical outcome in patients with open globe injuries in a tertiary ophthalmological centre in North-east India. METHODS: Case sheets of 79 patients undergoing surgery following open globe injuries at Sri Sankaradeva Nethralaya, Guwahati were studied retrospectively in terms of the type of injury, surgical interventions and final visual outcome. The period of study was from 1994-2005. Results: Injury was mild in 48 (60.8%), moderate in 17 (21.5%) & severe in 14 (17.7%) cases (International Ocular Trauma Classification). 46 (58.2%) cases had only primary repair, 27 (34.2%) had associated lens extraction, 12 (15.2%) had vitrectomy, 2 (2.5%) had retinal detachment surgery, one (1.3%) had intra-ocular foreign body removal, one (1.3%) evisceration.13 (16.5%) cases underwent secondary procedures. Final vision was 6\18 or better in 20 (25.3%), 6\18-6\60 in 14 (17.7%) and <6\60 in 15 (18.9%) cases. 10 (12.7%) cases developed phthisical changes. CONCLUSION: Present analysis reveals that open globe injuries can present in varying severity & though the overall prognosis is grave, prompt surgical intervention can result in better visual outcome.

Diagnóstico histopatológico das lesões oculares em centro de referência / Ocular histopathologic diagnosis in a reference center

Objetivo: Estabalecer os diagnósticos histopatológicos das lesões oculares em centro de referência. Correlacionar os diagnósticos mais prevalentes com sexo e idade. Local: Fundação Altino Ventura (FAV), Recife/PE - Brasil. Método: Estudo realizado no laboratório do Departamento de Patologia do Hospital das Clínicas da Universidade Federal de Pernambuco no período de 10 anos. Tratou-se de um estudo transversal retrospectivo cujos dados coletados foram sexo, idade, local de realização da biópsia e diagnóstico histopatológico contidos nas fichas dos pacientes biopsiados. Resultados: Das 285 biópsias analisadas, 256 eram lesões benignas e 29 lesões malignas, das quais 41,4 por cento carcinomas basocelulares de pálpebra, 13,8 por cento retinoblastomas, 10,3 por cento carcinoma epidermóide de conjuntiva, 6,0 por cento carcinoma adenóide cístico de órbita, 6,9 por cento neoplasia maligna de células pequenas em órbita, 3,4 por cento melanoma melanocítico de conjuntiva, 3,4 por cento melanoma de coróide e 3,4 por cento fibrossarcoma de órbita.