OUTCOME OF THE MANAGEMENT OF CORNEAL PERFORATION BY TENON PATCH GRAFT, MULTI LAYERS AMG AND CORNEO-SCLERAL TISSUE

A., Moin Uddin,; M., Mujtaba,; Ch., Sultana,; R., Das,; A., Salam,; M., Muntakim,

doi:10.21608/ejco.2022.280970

OUTCOME OF THE MANAGEMENT OF CORNEAL PERFORATION BY TENON PATCH GRAFT, MULTI LAYERS AMG AND CORNEO-SCLERAL TISSUE

Document Type : Original articles: include clinical trials, interventional research, Basic researches and clinically relevant laboratory investigations

Authors

Cornea & anterior segment, dept., Ispahani Islamia Eye Institute & Hospital, Dhaka, Bangladesh.

10.21608/ejco.2022.280970

Abstract

Purpose: The aim of the study was to make an update in the field of outcome of the impending
perforation by Tenon patch graft, multi layers AMG and Corneo-scleral tissue in a tertiary eye
hospital in Bangladesh. Methods: The study was conducted between January 2018 and January 2020.
A total of 100 patients were included in this study. Hospital information systems and the
International Classification of Diseases (ICD) were used to retrieve the medical records of the
patients. A well-developed questionnaire contains demographic information, patient general health
status, and head of compliance, ocular examination, clinical test, procedure, and follow-up < br />information. A study protocol was developed and approved by the ethical committee. Results: In
this study a large number of corneal perforation patients were adults and a few were younger. The
age and place of living of corneal perforation patients were found statistically significant at the .001
(x2= 42.87; Gamma V= .65, df = 18). We found a strong association between patient level of education
and types of complications (x2= 36.58; Gamma V= .19, Lamda λ = .21 DF = 20; Sig; P= < .01, OR 4.6,
95% CI 4.1 to 7.9). Surgical outcome success rate was 92% following the structural integrity
maintained and 15% of 2nd intervention in the absence of corneal tissue. Finding suggested that
surgery complication is decreasing with increase the level of education of the patient. The majority
of the patients did not attend regular follow up and this was one the major cause of poor outcome of
the visual acuity. There is a strong association between surgery complication and structural integrity
(x2= 100; Gamma V= .53, df = 9, p < 001, OR 5.8, 95% CI 4.8 to 11.5%). Conclusion: Patient low
level of awareness is associated with the missing of follow up and this increase the chance of
complications. The structural integrity-maintained outcome suggest that the scarcity of corneal
tissue structure of eye ball in developing countries like Bangladesh can be minimized by using
tenons patch with conjunctival hood or multi-layer AMG or Corneo scleral patch graft.

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