Dr. DEEKSHA THORAT

, Dr. MEHUL SHAH, Dr. SHREYA SHAH, DR. RAUNAQ KHANNA

Abstract

INTRODUCTION: CORNEAL PERFORATIONS ARE NOT JUST OPHTHALMIC EMERGENCIES BUT CAN BE A NIGHTMARE FOR RURAL TERTIARY CENTRES. THIS VIDEO HIGHLIGHTS COST EFFECTIVE TECHNIQUES TO MAINTAIN GLOBE INTEGRITY AFTER A STERILE CORNEAL PERFORATION.

METHOD: EASY AVAILABILTY OF GRAFTS IS AN IMPORTANT FACTOR FOR RURAL SETUPS WITH CHALLENGES OF INFRASTRUCTURE. APPROPRIATE DECISION MAKING IS GUIDED BY THE LOCATION, SIZE AND UNDERLYING ETIOLOGY OF THE PERFORATION. PERFORATIONS< 2MM ARE SEALED USING FIBRIN BIOLOGICAL ADHESIVE WHICH INDUCES LESS INFLAMMATION, 2-3 MM ARE SEALED USING CYANOACYLATE GLUE . LARGER PERFORATIONS >4 MM ARE MANAGED BY AUTOLOGOUS GRAFTS LIKE CONJUCTIVAL FLAP OF GUNDERSON WITH ITS VASCULARITY FOR IMPROVED CORNEAL HEALING AND TENON PATCH GRAFT WITH SUTURES WHICH PROVIDES STRENGTH, EASY AVAILABILITY AND DOES NOT INDUCE IMMUNE REACTION.

CONCLUSION: A SHORTAGE OF DONOR CORNEAS, LACK OF INFRASTRUCTURE FOR TRANSPLANTATIONS CAN BE COMBATTED BY IMPLEMENTING THESE EASILY AVAILABLE TECHNIQUES