Tape Splint Tarsorrhaphy for Persistent Corneal Epithelial Defects

• Published in: American journal of ophthalmology 2022-05, Vol.237, p.235-240
• Main Authors: MIMOUNI, MICHAEL, LIU, EUGENE S., DIN, NIZAR, GOUVEA, LARISSA, ALSHAKER, SARA, COHEN, EYAL, KIM, DOOHO B., CHAN, CLARA C.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Contact lenses; Cornea - surgery; Corneal Diseases - therapy; Corneal transplantation; Corneal Transplantation - adverse effects; Corneal Ulcer - surgery; COVID-19; Etiology; Eye surgery; Humans; Middle Aged; Ophthalmology; Patients; Retrospective Studies; Splints; Stem cells; Treatment Outcome
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2021.12.006

To report outcomes of tape splint tarsorrhaphy (TST) for persistent corneal epithelial defects (PCED). Retrospective, interventional case series. The study population was consecutive patients with a PCED (14 days or longer) treated at a tertiary cornea clinic with TST. Patients with a corneal epithelial defect that did not respond to treatment with a bandage contact lens were included. Patients with a follow-up time of less than 3 months were excluded. Time to PCED resolution was the main outcome measure. Thirty-four eyes of 33 patients (mean age 62.9 ± 17.8 years; range, 27-90 years) were included in this study. The main etiologies of the PCED were post keratoplasty (n = 15), herpes simplex virus (n = 4), superficial keratectomy (n = 3), neurotrophic cornea (n = 4), fungal keratitis (n = 2), exposure keratopathy (n = 2), failed graft (n = 1), peripheral ulcerative keratitis (n = 1), rosacea (n = 1), and stitch abscess (n = 1). Mean ± SD time from PCED presentation to TST was 58.9 ± 106.3 days (range, 14-390 days). The mean ± SD area of the PCED was 25.1 ± 15.7 mm2 (range, 0.50-42.0 mm2). After TST, resolution of the PCED was achieved in 29/34 eyes (85.3%) without the need for additional interventions within 22.5 ± 24.3 days (range, 2-105 days). The mean ± SD logMAR best-corrected visual acuity improved significantly from 1.11 ± 0.41 to 0.83 ± 0.70 (P = .02). There were no complications attributed to TST and 2 patients elected to discontinue due to discomfort. TST achieved resolution of PCEDs secondary to various etiologies in 85.3% of eyes, with significant improvement in vision demonstrated. This simple, inexpensive, noninvasive technique may be considered for patients with PCEDs.