An 83-year-old male with advanced Alzheimer's disease, insulin-dependent diabetic with 35 years of evolution, who came to our emergency department due to a 2-day history of ocular pain in the right eye.
The VA could not be objectified due to lack of cooperation.
The evaluation of the anterior segment determined a 2.5mm diameter corneal ulcerative lesion with a central perforating endothelial pore of approximately 1mm, without concomitant infectious or inflammatory process.
The patient had no history of trauma.
With the diagnosis of sterile non-traumatic corneal perforation to filiation, the urgent closure of the lesion was performed.
Under topical anesthesia and in the operating room to facilitate collaboration, a tapeil® patch was prepared, which was shortened so as to overcome the ulceration edges, for full recovery.
After hydration with saline solution for 5 seconds, it was applied immediately with the active part (partite) of the corneal defect, pressing and gently moistening the sponge for 3 minutes with a firm forceps until secure.
1.
Without removing excess material, the eye was occluded.
After 36 hours of occlusion, the sponge was not detached from the application site and a fibrinoid material occluding the perforating endothelial pore was observed.
No sponge remains were found displaced or in the conjunctival sac funds.
A therapeutic lens was safely applied and it was started with topical antibiotic, cyclopeptide and medroxyprogesterone treatment.
72 hours after application, corneal thinning persisted over the perforation site, with complete closure and good anterior chamber depth.
Subsequent controls one week and one month later confirmed total corneal closure, which was able to remove the therapeutic lens and the medical treatment described.
