Penetrating Keratoplasty With Small-Diameter and Glycerin-Cryopreserved Grafts for Eccentric Corneal Perforations

PURPOSE: To report the outcome of penetrating keratoplasty with small-diameter and glycerin-cryopreserved grafts for eccentric corneal perforation. METHODS: In this retrospective consecutive case series, 15 eyes of 15 patients with eccentric corneal perforations underwent small-diameter penetrating keratoplasties with glycerin-cryopreserved grafts. The corneal grafts used in this study were 2.5-4.5 mm in size and preserved at -20 degrees C in pure glycerin for 6 months to 5 years. The donors were secured with 6-8 sutures that spared the visual axis. The follow-up ranged from 7 to 36 months. Clarity of the grafts was observed, and changes in visual acuity and keratometric astigmatism were analyzed. RESULTS: : Global integrity was achieved in all eyes. All grafts remained clear at the end of the follow-up time. No immune rejection was detected. No complicated cataract or secondary glaucoma was developed. The uncorrected visual acuity improved from preoperative 20/2000 approximately 20/60 to postoperative 20/40 approximately 20/20, and the best-corrected visual acuity after surgery was 20/30 or better. The mean value of keratometric astigmatism was 2.47 +/- 0.78 diopters postoperatively. CONCLUSIONS: Small-diameter penetrating keratoplasty seems to be effective in treating various eccentric corneal perforations. Glycerin-cryopreserved donors may be a suitable alternative to fresh material for this technique, which solves the problem of shortage in supplying corneas and can be used in an emergency.