Abstract:AIM: To describe the use of a combination of 2 preserved homologous corneoscleral patches for the emergency repair of a perforated cornea with extruded lens and exposed vitreous in a lady who had undergone tectonic penetrating keratoplasty. METHODS: A 49-year-old lady had presented with an extensive fungal corneal ulcer which was complicated by a descemetocele and microperforation. She had undergone a therapeutic cum tectonic penetrating keratoplasty. However, she developed a spontaneous large corneal perforation with expulsion of her crystalline lens with exposed vitreous. In view of the urgent need to cover the defect, a double graft combining 2 preserved full-thickness corneoscleral patches were used as donor cornea was not immediately available. RESULTS: The surgery was successful in not only restoring the integrity of the globe but also saved her of evisceration. Over the next few weeks, the graft began to heal and there was good re-epithelisation except over the scleral part of the patch. There were no signs of infection and she was able to maintain a vision of hand movement. She was put on a bandage contact lens in view of the epithelial defect. She has also been advised about an elective repeat penetrating keratoplasty. CONCLUSION: In the absence of a corneal button for grafting, one or more preserved homologous corneo-scleral patch(es) may be used temporarily for covering large corneal defects.
