- Corneal laceration may result from trauma which ranges from nonperforating
trauma to full thickness lacerations (rupture globe) that may involve
intraocular structures.
- Management:
- In a nonperforating laceration, descemet's membrane perforation
has to be ruled out. It is especially important to observe the
integrity of the anterior chamber.
- Bandage soft contact lens may be sufficient for a small
self-sealing, beveled or edematous coneal laceration to protect
the wound as it heals.
- Cyanoacrylate tissue adhesive may be indicated for treatment
of small perforating wounds with poor central apposition or stellate
lacerations that do not self-seal along with bandage contact lens.
- Full thickness lacerations (rupture globe) greater than
2-3 mm require suturing to structurally restore the globe's integrity.
- General anesthesia is indicated particularly if the lacerations
are large with possible expulsion of intraocular contents
- Extensive lacerations with avulsion and large amount of
tissue loss may eventually require lamellar or penetrating keratoplasty.
- Peripheral iridotomy should be done in lacerations extending
to the limbus to prevent the formation of anterior synechiae.
- In corneal lacerations complicated with iris prolapsed,
the iris viability should be evaluated for possible repositioning.
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