{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:10:15Z","timestamp":1789495815936,"version":"build-2803163510"},"reference-count":23,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T00:00:00Z","timestamp":1695254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vision"],"abstract":"<jats:p>Severe corneal ulcerations, causing major keratolysis with large perforation of the cornea or extending to the limbal region, are an ophthalmic emergency. In these cases, a larger corneoscleral graft can be transplanted to restore tectonic integrity, alleviate pain, save vision, and prevent loss of the eye. Chart review of 34 patients with a corneoscleral graft \u22659.5 mm was conducted. Primary endpoints of the study were tectonic stability defined as no need for another keratoplasty or enucleation. In addition, visual acuity, postoperative complications, and secondary procedures were analyzed. In total, 12 patients (35%) were female. The mean age at transplantation was 65 \u00b1 19 years. The underlying disease was a perforated infectious corneal ulcer in 30 cases (88%). Mean follow up was 675 \u00b1 789 days. Tectonic stability at the end of the follow-up was maintained with a probability of 56% in a Kaplan\u2013Meier analysis. Another penetrating keratoplasty was necessary in six cases (17%) and enucleation in five cases (15%). A corneoscleral transplant remains a viable treatment option to prevent enucleation in severe keratolysis. In our study, this was possible in about half of the cases. Postoperative complications, secondary surgeries, and markedly reduced visual acuity put the advantages into perspective.<\/jats:p>","DOI":"10.3390\/vision7030062","type":"journal-article","created":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T04:53:05Z","timestamp":1695271985000},"page":"62","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Use of Corneoscleral Grafts to Maintain Tectonic Stability in Severe Keratolysis"],"prefix":"10.3390","volume":"7","author":[{"given":"Lennart M.","family":"Hartmann","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Ulm University, Prittwitzstra\u00dfe 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Juergen","family":"Buchwald","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ulm University, Prittwitzstra\u00dfe 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Elhardt","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ulm University, Prittwitzstra\u00dfe 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9833-2200","authenticated-orcid":false,"given":"Efstathios","family":"Vounotrypidis","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ulm University, Prittwitzstra\u00dfe 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ulm University, Prittwitzstra\u00dfe 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian M.","family":"Wertheimer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ulm University, Prittwitzstra\u00dfe 43, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1097\/ICO.0000000000001666","article-title":"Etiology of Global Corneal Blindness and Current Practices of Corneal Transplantation: A Focused Review","volume":"37","author":"Mathews","year":"2018","journal-title":"Cornea"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"253","DOI":"10.22336\/rjo.2018.39","article-title":"Emergency penetrating keratoplasty in corneal perforations","volume":"62","author":"Stamate","year":"2018","journal-title":"Rom. 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