UNASSIGNED: Corneal perforation due to severe melting is a very dangerous, sight-threatening condition requiring immediate management due to the high risk of endophthalmitis and critical hypotony. In the case of perforated corneal grafts, retransplantation is usually postponed to avoid the detrimental effects of inflammation on the new graft. We describe the first case of the use of a TutoPatch graft for emergency replacement of a lamellar graft perforation over acute infectious total melting.
UNASSIGNED: A 42-year-old male patient presented to the Emergency Department with pain in the left eye, which was red photophobic. He had been treated with bilateral deep anterior lamellar keratoplasty (DALK) for advanced keratoconus 5 years previously and had been experiencing recurrent corneal ulcers in the left eye within the last 8 months. Clinical examination documented corneal perforation over acute infectious melting involving the total graft surface in the left eye. The infected graft was removed along with the perforated infected residual Descemet membrane, and a double-layer TutoPatch covering was sutured to the host\'s margin with 10.0 nylon. The covering was left in place for three weeks, allowing the patient to undergo retransplant three weeks later without complications.
UNASSIGNED: TutoPatch covering can be safely used as an easy-to-preserve emergency material for a temporary bridge to retransplantation in large acute infectious corneal melting.

BACKGROUND: After surgery for oral cavity cancer, superficial surgical defects are usually covered with a skin graft that can be harvested with different thicknesses depending on the reconstructive need. Despite its popularity and efficacy, this solution has the disadvantage of excessive harvesting times and scarring of the donor site. Other surgeons have proposed the use of bovine pericardium as a reconstructive solution. Its use in otorhinolaryngology especially after oral cavity surgery has never been reported.
OBJECTIVE: The aim of this manuscript is to present our preliminary experience with the use of a collagen membrane obtained from bovine pericardium in the reconstruction of small and superficial defects after transoral resection of oral cavity tumors.
METHODS: A bovine collagen membrane was used to cover surgical defects in 19 consecutive patients undergoing transoral resection of small/superficial oral cancers. Photographs were obtained in the postoperative period to follow the healing process. We analyzed the pro and cons of this tool, recorded data on postoperative chewing-, speech- and taste-related quality of life, and tested the most appropriate settings providing the best reconstructive result.
RESULTS: The bovine collagen membrane allowed us to cover surgical defects of varying size in different oral sites. Shaping and placement proved to be simple. The membrane facilitated physiologic tissue repair: after one month it was completely absorbed and replaced by the patient\'s own mucosa. No adverse features were observed in the cohort.
CONCLUSIONS: A bovine collagen membrane can represent a fast and easy solution in cases of split-thickness defect. Unlike a skin graft, it is not associated with donor site morbidity and allows the patient\'s own mucosa to be restored with a more physiological result.

OBJECTIVE: To compare the use of human donor sclera with bovine pericardium as patch graft material for a glaucoma drainage device (GDD), with respect to the incidence of tube exposure, and to study the role of a drainage suture.
METHODS: All GDD surgeries between 2010 and 2014 performed at the VU Medical Center were examined in this comparative, retrospective cohort study. A total of 244 cases were included; 163 in the human donor sclera cohort and 81 in the bovine pericardium cohort with a median follow-up of 31 and 36 months, respectively. The primary outcome measure was occurrence of tube exposure. Survival analysis for tube exposure was carried out and Kaplan-Meier curves compared. Secondary outcomes were postoperative intraocular pressure (IOP), number of glaucoma medications and the effect of a drainage suture.
RESULTS: In the bovine pericardium cohort, eleven (13.6%) eyes developed tube exposure compared to none in the human donor sclera cohort. Their Kaplan-Meier survival curves differed significantly from each other (χ² = 21.1, p < 0.001, log-rank test). Mean IOP and number of glaucoma medications did not differ significantly between patch graft materials at three months of follow-up. The use of a drainage suture directly lowered IOP after surgery in both cohorts. Within the bovine pericardium cohort, eyes with a drainage suture experienced more tube exposure, although this difference was not statistically significant (p = 0.09).
CONCLUSIONS: Human donor sclera leads to less tube exposure than bovine pericardium. A drainage suture directly lowers IOP after surgery. With bovine pericardium, but not with donor sclera, exposure tends to be enhanced by a drainage suture.

Solid eye platelet-rich plasma (E-PRP) concentrates platelets in a small volume of plasma which contains a high concentration of important growth factors and cell adhesion molecules. These cell adhesion molecules and growth factors occupy a major role in wound healing and enhance the physiological procedure at the site of the injury or the surgery. There are different materials used to tectonically maintain the solid clot attached at the site where treatment is necessary. Although AM may be used for this purpose, other biomaterials such a bovine pericardium or autologous fibrin membrane are at least as effective with less interdonor variations, no biological hazards, providing a better surgical alternative than the biologically so variable amniotic membrane patch. Solid platelet-rich plasma in the form obtained in ophthalmology, E-PRP, is a reliable and effective surgical coadjuvant to promote corneal wound healing in severe corneal ulcers and corneal perforations, and may be associated with other ocular surface reconstruction procedures.
BACKGROUND: Supported in part by a grant from the Spanish Ministry of Science and Innovation, Centro para el Desarrollo Tecnológico Industrial (CDTI), CENIT: \"Customized Eye Care\", CeyeC (CEN-20091021).