Sterile non-traumatic corneal perforation treated with Tachosil®

Abstract

Case report

An 83-year-old male reported to the emergency room with red eye and ocular pain. The slit-lamp examination showed a central corneal perforation of 1 mm in diameter, with no associated infection or inflammatory process. The patient had no history of trauma. It was decided to apply a patch of Tachosil^® at the site of corneal perforation. After 36 h of occlusion, a layer of fibrin covered the perforation, closing the defect. Successful healing of the corneal perforation was observed in the follow-up, with no recurrences of the process.

Conclusions

Tachosil^® is collagen sponge with human fibrin and human thrombin used in cardiological and neurosurgical surgery for haemostasis and the occlusion of vessels and meninges. We present the first indication in ophthalmology of Tachosil^® as an effective alternative in the treatment of sterile non-traumatic corneal perforations less than 1.5 mm in size.

Resumen

Caso clínico

Varón de 83 años que acude a urgencias por dolor ocular en ojo derecho y enrojecimiento. En la exploración se objetivó una lesión perforante corneal central de 1 mm de diámetro sin proceso infeccioso o inflamatorio concomitante ni antecedentes traumáticos. Procedimos al cierre urgente del defecto, aplicando un parche de Tachosil^® sobre la zona perforada. Tras 36 horas de oclusión un material fibrinoide ocluía la perforación cerrando el defecto. En el posterior seguimiento no se presentaron recurrencias ni efectos adversos persistiendo el sellado completo del defecto.

Conclusiones

Tachosil^® es una esponja colágena de fibrinógeno y trombina humanos utilizada para favorecer la hemostasia y la reparación tisular en cirugías cardíacas, urológicas y neuroquirúrgicas. Presentamos la primera indicación oftalmológica de Tachosil^® como una posible alternativa efectiva y de fácil uso en las perforaciones corneales no traumáticas estériles menores de 1,5 mm.