Original articleMultilayered Gore-Tex Patch for Temporary Coverage of Deep Noninfectious Corneal Defects: Surgical Procedure and Clinical Experience
Section snippets
Methods
The medical records of all patients treated with a temporary Gore-Tex patch between 2000 and 2008 were reviewed. The study was designed as retrospective interventional case series. Mean follow-up was 33.9 ± 29.2 months (range, 1.5 to 108 months). Thirty-eight consecutive patients (24 male, 14 female) with deep noninfectious corneal defects were included. One patient received a Gore-Tex patch in both eyes. Thirteen eyes had perforated corneal defect ulcers; in 11 eyes, a descemetocele was
Follow-up until Gore-Tex Patch Explantation
The Gore-Tex patches remained in place for a mean of 6.4 months (SD, 8.3 months; range, 4 days to 32 months). In 4 cases (10.3%), the patch has not been removed so far. Two patients died before the patch was removed. Indications for graft explantation were as follows: in 13 cases (33.3%), an HLA-matched keratoplasty was conducted (Figure 1, Bottom). Of these, 3 transplantations were without mismatches (MMs), 4 transplants had 1 MM, 4 transplants had 2 MMs, and 2 transplants had 3 MMs. In 14
Discussion
To our knowledge, the Gore-Tex patch as a therapeutic option to cover corneal defects has been reported only in several small case series.1, 10, 11 After the first report of Legeais and associates, who described watertight closure of the anterior chamber with a Gore-Tex patch,10 Huang and associates reported 3 cases of Gore-Tex patch coverage that were histologically evaluated.11 In the first case, a perforated corneal ulcer with progressive tissue melting could be stabilized for 2 months until
Florian Rüfer, MD, completed his medical degree at the Faculty of Medicine at Hannover Medical School, Germany. After residency at the University Hospitals of Hannover and Kiel, he has been working as permanent staff member in the Department of Ophthalmology at University Medical Center Schleswig-Holstein, Kiel, since 2007. His primary research interests are glaucoma and anterior segment surgery.
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Florian Rüfer, MD, completed his medical degree at the Faculty of Medicine at Hannover Medical School, Germany. After residency at the University Hospitals of Hannover and Kiel, he has been working as permanent staff member in the Department of Ophthalmology at University Medical Center Schleswig-Holstein, Kiel, since 2007. His primary research interests are glaucoma and anterior segment surgery.
Bernhard Nölle, MD, completed his medical degree at the Faculty of Medicine, Christian-Albrechts-University of Kiel, Germany. Doctoral thesis in 1992: Anti-Retina-Antibodies at the Institute of Immunology, Kiel. After residency in Internal Medicine 1986 to 1987, he completed ophthalmology in 1993. He is working as assistant medical director in the Department of Ophthalmology at University Medical Center Schleswig-Holstein, Kiel. Main clinical and scientific interests are ocular inflammation, systemic vasculitis, corneal transplantation, and anterior segment surgery.