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Purpose <p>To evaluate the outcomes of autologous Tenon’s patch graft (TPG) in impending or full thickness corneal perforations in pediatric patients with infectious keratitis.</p> Patients and methods <p>In this prospective, interventional case series, 26 eyes of 26 children (age ≤ 16 years) presenting with 3–5 mm impending or full thickness corneal perforations secondary to bacterial or fungal keratitis underwent autologous TPG. Tenon’s tissue was harvested, fashioned to slightly exceed the defect diameter, and secured with interrupted 10–0 nylon sutures, followed by bandage contact lens placement. Postoperative topical antimicrobial therapy was tailored to the causative organism. Patients were examined preoperatively and followed up for 3 months. Outcome measures included best corrected visual acuity (BCVA), Seidel testing, anterior chamber depth evaluation, time of epithelialization and scar formation, and assessment by anterior segment optical coherence tomography (AS-OCT).</p> Results <p>The cohort comprised 14 males and 12 females, mean age 9.4 ± 3.3 years. At three months, 24 eyes (92.3%) achieved complete anatomical healing, with 25 eyes (96.2%) maintaining a formed anterior chamber and testing Seidel negative. Mean LogMAR BCVA improved from 1.75 ± 0.59 to 1.32 ± 0.56 at 3 months (<i>p</i> = 0.001). AS-OCT demonstrated complete stromal integration without leucoma in 17 eyes (65.4%) and healed grafts with adherent leucoma in 7 eyes (26.9%). Two eyes (7.7%) required therapeutic penetrating keratoplasty for ongoing infection; one eye (3.8%) needed suture augmentation. No major intraoperative complications occurred.</p> Conclusion <p>Autologous Tenon’s patch graft for medium sized infectious corneal perforations in pediatric patients yields high anatomical success, significant visual improvement, and minimal complications. It represents a valuable option in settings where donor tissue is scarce or emergency intervention is required.</p>

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Tenon Patch Graft in Management of Impending or Full Thickness Corneal Perforation in Pediatric Patients

  • 期刊论文

  • 发表日期：

    2026年4月8日

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  • Hesham Mohamed El Mazar,
  • Mohamed Mostafa Al Makhlasawy,
  • Ahmed Ibrahim Basiony

摘要

Purpose

To evaluate the outcomes of autologous Tenon’s patch graft (TPG) in impending or full thickness corneal perforations in pediatric patients with infectious keratitis.

Patients and methods

In this prospective, interventional case series, 26 eyes of 26 children (age ≤ 16 years) presenting with 3–5 mm impending or full thickness corneal perforations secondary to bacterial or fungal keratitis underwent autologous TPG. Tenon’s tissue was harvested, fashioned to slightly exceed the defect diameter, and secured with interrupted 10–0 nylon sutures, followed by bandage contact lens placement. Postoperative topical antimicrobial therapy was tailored to the causative organism. Patients were examined preoperatively and followed up for 3 months. Outcome measures included best corrected visual acuity (BCVA), Seidel testing, anterior chamber depth evaluation, time of epithelialization and scar formation, and assessment by anterior segment optical coherence tomography (AS-OCT).

Results

The cohort comprised 14 males and 12 females, mean age 9.4 ± 3.3 years. At three months, 24 eyes (92.3%) achieved complete anatomical healing, with 25 eyes (96.2%) maintaining a formed anterior chamber and testing Seidel negative. Mean LogMAR BCVA improved from 1.75 ± 0.59 to 1.32 ± 0.56 at 3 months (p = 0.001). AS-OCT demonstrated complete stromal integration without leucoma in 17 eyes (65.4%) and healed grafts with adherent leucoma in 7 eyes (26.9%). Two eyes (7.7%) required therapeutic penetrating keratoplasty for ongoing infection; one eye (3.8%) needed suture augmentation. No major intraoperative complications occurred.

Conclusion

Autologous Tenon’s patch graft for medium sized infectious corneal perforations in pediatric patients yields high anatomical success, significant visual improvement, and minimal complications. It represents a valuable option in settings where donor tissue is scarce or emergency intervention is required.