Multilayer Collagen Sheet Graft for Corneal Perforation with a Corneal Ulcer

ABSTRACT

Purpose@#To report a rare case of corneal perforation treated with a multilayer collagen sheet graft transplantation after amniotic membrane graft failure to prevent corneal perforation in a fungal corneal ulcer.Case summary: A 64-year-old woman with a past history of rheumatoid arthritis 1 year prior was transferred to our hospital due to unresponsive treatment of a corneal ulcer. Although the corneal ulcer of the right eye was treated with antibiotics for 10 days, loss of the corneal epithelial layer and corneal stromal infiltration were observed on examination. A culture test was conducted on the corneal ulcer that identified the pathogen as the Paecilomyces strain. Corneal perforation occurred 1 month after undergoing an amniotic membrane graft to prevent this outcome. A multilayer collagen sheet graft (Aongen®; Pharos Tech Medical, Seoul, Korea) was applied at the perforated corneal ulcer site without a donor cornea. One year after this operation, visual acuity has not been restored; however, corneal perforation of the ulcer site has not progressed. @*Conclusions@#If there is no donor cornea, partial corneal transplantation using a multilayer collagen sheet graft is thought to be a therapeutic method to treat corneal perforation in cases involving impacted corneal perforation or corneal perforation that occurs in corneal disease.