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Tectonic epikeratoplasty with ethanol-stored donor corneas

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Abstract

To evaluate the efficacy and outcomes of tectonic epikeratoplasty with use of ethanol-preserved corneal grafts for the management of perforated corneal melts. The present retrospective case series includes 10 eyes which underwent tectonic epikeratoplasty for perforated corneal melts. The stromal remainders of Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) graft preparation were stored in 95% ethanol and used as emergency tectonic grafts for restoring globe integrity after sterile and infectious perforated corneal melts. In 6 cases with subtotal corneal melt, DMEK remainders (endothelium-denuded corneoscleral buttons) were used for ‘limbus to limbus’ tectonic epikeratoplasty and in 4 cases DSAEK remainders (anterior stroma) were used to seal focal perforated melts. Graft storage time was 5.1 ± 4.9 (ranging from 0.5 to 17) months. The surgeries were successful in all cases with restitution of the globe integrity. During the postoperative course 4 cases developed a graft melt (corneoscleral button for limbus to limbus tectonic epikeratoplasty, n = 3; lamellar patch, n = 1) within 2–6 months after the initial procedure. Three patients underwent successful repeat tectonic epikeratoplasty. In the fourth case of graft melt the globe was enucleated due to underlying expulsive haemorrhage and severe pain. The short-term results of the present case series suggest that the use of ethanol-stored stromal remainder of donor corneas after endothelial keratoplasty is an efficient temporary measure for tectonic restoration of perforated corneas.

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Authors and Affiliations

  1. First Department of Ophthalmology, Medical School of Athens, University of Athens, Athens, Greece

    Apostolos Lazaridis, Dimitrios Brouzas, Ilias Georgalas, George Kymionis, Klio Chatzistefanou, Chryssanthi Koutsandrea & Konstantinos Droutsas

  2. Department of Ophthalmology, Philipps University, Marburg, Germany

    Apostolos Lazaridis, Walter Sekundo & Konstantinos Droutsas

Authors
  1. Apostolos Lazaridis
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  2. Dimitrios Brouzas
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  3. Walter Sekundo
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  4. Ilias Georgalas
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  5. George Kymionis
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  6. Klio Chatzistefanou
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  7. Chryssanthi Koutsandrea
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  8. Konstantinos Droutsas
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Correspondence to Apostolos Lazaridis.

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Lazaridis, A., Brouzas, D., Sekundo, W. et al. Tectonic epikeratoplasty with ethanol-stored donor corneas. Cell Tissue Bank 19, 637–644 (2018). https://doi.org/10.1007/s10561-018-9714-1

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  • DOI: https://doi.org/10.1007/s10561-018-9714-1

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