Purpose: To report on the use of the Eckardt keratoprosthesis as an emergency temporary tectonic seal for a full-thickness, large decentered corneal perforation.
Methods: Case report and review of the literature.
Results: A 47-year-old male patient with myotonic dystrophy presented with a large corneal perforation as a complication of chronic ulceration caused by lagophthalmia and recurrent herpetic keratitis. The perforation was triggered by a superinfection with Gram-positive bacteria. In an emergency setting where no donor cornea was available, the Eckardt keratoprosthesis was sutured into the debrided corneal defect as a tectonic measure. A secondary procedure, consisting of open sky cataract extraction combined with penetrating keratoplasty was performed 3 weeks later. During this period, the prosthesis was well tolerated and the anterior chamber stayed well formed.
Conclusions: The Eckardt keratoprosthesis allowed us to convert what would have been an emergency à chaud keratoplasty into a well-controlled elective procedure. In our case, the silicone prosthesis was well tolerated during the 3-week period while awaiting final repair with a corneal donor button.