Clinical Study

Improvement of Amniotic Membrane Method for the Treatment of Corneal Perforation

Figure 1

Surgical steps for corneal perforation surgery. For a smaller ulcer and perforation with an abrupt edge, AMR is pushed into the perforation and fixed with cross-stitch fixation as shown in (a). For the larger perforation, first, AM was folded into a roll and plugged into the perforation. Second, a bilayer AM was covered by the roll and ulcer with the epithelial side up and secured with 10-0 nylon sutures (white arrow in (b)). Third, 0.3 mL of 20% C3F8 (perfluoropropane) was injected into the anterior chamber (thin black arrow in (b)). Finally, a larger piece of AM was applied over the entire cornea as a temporary patch and anchored with 2 laps running 10-0 nylon sutures to the corneal limbus and perilimbal episclera (thick black arrow in (b)). The surgical scheme is shown in (c). Note: the AMR was inserted into the ulcer perforation as a filling material after which the bilayer AM was placed on the ulcer as a cover. Thereafter the big AM was located over the entire cornea with the epithelial side up as an additional cover.
(a)
(b)
(c)