Use of human fibrin glue and amniotic membrane transplant in corneal perforation

Purpose. To repair corneal perforation using human fibrin glue (HFG) and am niotic membrane transplant (AMT). Methods. Three patients in whom central c orneal perforations, approximately 2 mm in diameter, occurred after ocular or systemic disease were successfully cured using HFG and AMT. The techniqu e consists first of using a high-viscosity sodium hyaluronate: viscoelastic material to restore anterior chamber depth followed by a debridement of th e ulcer. The perforation site is filled with the HFG to corneal surface lev el. The so-formed plug is then secured with an AMT to avoid its extrusion. An extended-wear bandage contact lens and topical antibiotics were used in these patients for 3 weeks. Results. Total reepithelialization was observed after an average of 15 postoperative days. The AMT dissolved within 8 week s to uncover a whitish scar formed within the perforation sites. No complic ations were observed in any patients. After a follow-up period of 195-325 d ays, all corneas remained stable: there was no infection or ulcer recurrenc e. but some corneal scar thinning was observed in all three cases. Conclusi on. The described surgical approach using HFG and AMT allowed a successful repair of corneal perforations with a diameter of 2 mm associated with sign ificant loss of stroma. This method may be a good alternative to delay pene trating keratoplasty for treating corneal perforations, especially in acute cases in which graft rejection risk is high.