Table 1.
Previous cases of a tectonic posterior lamellar keratoplasty graft in managing impending or actual perforation.
| Author | Year | Region | Number of cases | Description | Type of procedure | Follow up | Outcomes | Final VA |
|---|---|---|---|---|---|---|---|---|
| Graue-Hernandez4 | 2012 | Mexico | 1 | Corneal thinning secondary to dry eye. | A tectonic DSAEK and amniotic membrane graft. | 8 months | Ocular surface healed quickly, and re-epithelization occurred over 2 weeks and lasted for follow-up. | NA |
| Nahum5 | 2016 | Israel and Italy | 3 | Case 1,2: Endothelial decompensation and sterile corneal perforation. Case 3- an impending corneal perforation. |
DSAEK | Case 1: 3 months Case 2: 1 year Case 3: 1 year |
All grafts remained clear throughout the follow-up. Case 1 underwent DALK on DSAEK with improved visual acuity. | Case 1–20/30 Case 2–20/60 Case 3–20/400 |
| Okada8 | 2016 | Japan | 1 | A corneal perforation of undetermined etiology. | Partial-thickness corneal button | 5 months | Seven weeks postoperatively, the corneal defect was closed and lasted for follow-up. | 6/6 |
| Jesse6 | 2017 | Switzerland | 1 | A perforated corneal ulcer due to neurotrophic keratopathy caused by previous recurrent herpetic keratitis. | A DSAEK graft. | 6 months | Re-bubbling was performed the day after and four 10–0 Nylon sutures were placed for 2 weeks those = The long-term follow-up showed stable and transparent cornea. | CF due to severe AMD. |
| Tourkmani7 | 2020 | United Kingdom | 4 | Case 1- perforation due to exposure keratopathy Case 2,3- perforation due to herpetic keratitis Case 4- corneal hydrops secondary to PMD. |
Cases 1–3: DSEK Case 4: hemi-DSEK | Case 1: 2 months Case 2:NA Case 3:NA Case 4:NA |
Case 1–4: Tectonic goal satisfactorily achieved. Case 4- patient underwent 2 re-floating attempts before anchoring suture placement due to repeated graft detachment. |
Case 1-NA, without visual potential. Case 2-NA Case 3-NA Case 4-NA |
DSEK; Descemet stripping endothelial keratoplasty, DSAEK; Descemet stripping automated endothelial keratoplasty, BCVA; best-corrected visual acuity, VA; visual acuity, CF; counting fingers, PMD; pellucid marginal degeneration, NA; not available, DALK; deep anterior lamellar keratoplasty.