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. 2024 May 18;17(5):831-837.
doi: 10.18240/ijo.2024.05.06. eCollection 2024.

Small-diameter acellular porcine corneal stroma for peripheral corneal ulceration treatment

Tian Liang  1 , Xia Wang  1 , Jie Wu  1 , Yan Cheng  1
Affiliations

Small-diameter acellular porcine corneal stroma for peripheral corneal ulceration treatment

Tian Liang et al. Int J Ophthalmol. .

Abstract

Aim: To evaluate the clinical efficacy of small-diameter acellular porcine corneal stroma (SAPS) for the treatment of peripheral corneal ulceration (PCU).

Methods: This retrospective clinical study included 18 patients (18 eyes) with PCU between April 2018 and December 2020. All patients had PCU and underwent lamellar keratoplasty with SAPS. Observation indicators included preoperative and postoperative best-corrected visual acuity (BCVA) and transparency of SAPS. The infection control rate in the surgical eye-lesion area was also calculated.

Results: Eighteen patients underwent lamellar keratoplasty with SAPS to treat PCU. None of the patients experienced rejection after 6mo (18/18) and 12mo (16/16) of follow-up. The BCVA (0.47±0.30) at the 6mo follow-up after operation was significantly improved compared with the baseline (0.99±0.80), and the difference was statistically significant (Z=-3.415, P<0.05). The BCVA at the 12mo follow-up after operation was not statistically significant compared to the 6mo (Z=0, P=1). With time, the SAPS graft gradually became transparent. At the 6mo (18/18) and 12mo (16/16) follow-up, none of the patients had recurrent corneal infection.

Conclusion: SAPS is clinically effective in the treatment of PCU, improving the patient's BCVA and reducing the incidence of rejection after keratoplasty.

Keywords: acellular porcine corneal stroma; infectious corneal ulcer; lamellar keratoplasty.

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Conflict of interest statement

Conflicts of Interest: Liang T, None; Wang X, None; Wu J, None; Cheng Y, None.

Figures

Figure 1
Figure 1. Preoperative and postoperative photographs of small-diameter acellular porcine corneal stroma for peripheral corneal ulceration in a left eye
A: An infection focus of about 2 mm on the cornea at 1:00-2:00 before surgery diagnosed fungal corneal ulcer of the left eye, and drug treatment was ineffective; B: Mild edema of corneal graft 3d after surgery; C: One month after surgery, edema of corneal graft gradually diminished, and the sutures were tightened without loosening; D: The corneal graft is translucent 3mo after the operation; E: All sutures have been removed 6mo after operation, and the corneal graft is transparent; F: The corneal graft was transparent 12mo after surgery.
Figure 2
Figure 2. Preoperative and postoperative photographs of small-diameter acellular porcine corneal stroma for peripheral corneal ulceration in a right eye
A: The corneal infection lesions at 7:00-8:00 before the operation diagnosed bacterial corneal ulcer of the right eye, and drug treatment was ineffective; B: Mild edema of corneal graft 3d after surgery; C: One month after surgery, the corneal graft edema was diminished, and the sutures were tightened without loosening; D: The corneal sutures have been removed 3mo after the surgery, and the graft is slightly edematous; E: All sutures have been removed 6mo after surgery, and the corneal graft is transparent; F: The corneal graft was transparent 12mo after surgery.
Figure 3
Figure 3. Corneal confocal microscope and anterior segment OCT before and after surgery of a small-diameter acellular porcine corneal stroma for peripheral corneal ulceration
A, B, and C: The preoperative corneal confocal microscope of the case in Figure 2, showed the infiltration of inflammatory cells in the corneal epithelial layer, stromal layer and endothelium; D, E and F: Photos of 12mo after surgery, all layers of inflammation were controlled; H: Preoperative anterior segment OCT showed corneal ulcers infiltrating into the corneal stroma layer; I: Twelve months after surgery, the anterior section OCT showed the position of the corneal graft and the recipient bed, and the corneal surface was smooth. OCT: Optical coherence tomography.
See this image and copyright information in PMC

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