A Retrospective Study of Corneal Perforations 1998-2010: Risk Factors, Treatments and Outcomes.

1. Marcela F. Eugarrios
2. Elsie Chan
3. Rasik B. Vajpayee
4. Marios Constantinou

1. Royal Victorian Eye and Ear Hospital
2. Royal Victorian Eye and Ear Hospital
3. Center for Eye Research Australia
4. Center for Eye Research Australia

Purpose To identify the associated factors and study the clinical and treatment characteristics of corneal perforations in a tertiary care hospital.

Methods A retrospective medical record review of all public patients who presented with a corneal perforation at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia from May 1987 through July 2010.

Results One hundred and fourteen patients were included in the study. The older than 70 age group composed 68.4% of patients presenting with corneal perforations. Major ocular factors associated were Herpes Simplex virus (25%), dry eyes (16%), and glaucoma (7%). Most common associated systemic factor was rheumatoid arthritis (17%). Most corneal perforations were located centrally (41%) especially in cases of Herpes Simplex virus manifestation (43%). The treatment most often chosen was application of cyanoacrylate glue with bandage contact lens placement (49%). At presentation the majority of patients (28%) had visual acuity of hand motion which was also the best corrected visual acuity seen after procedures in 15% of cases. The most common complication observed was glue dislodgement in 30% of cases. Enucleation was done in 11% of cases, and evisceration in 8%.

Conclusions Corneal perforations are mostly seen in the elderly age group associated with chronic degenerative pathology and ocular infectious disease. The treatment of choice is cyanoacrylate corneal gluing with bandage contact lens and in those eyes not recoverable enucleation was the modality used.