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Purpose  To report a surgical technique and the surgical outcomes of individualized penetrating keratoplasty (PK) using edge-trimmed glycerol-preserved donor corneas for perforated corneal ulcers.    Methods  Fourteen perforated eyes from 14 patients who underwent individualized PK using edge-trimmed glycerol-preserved donor corneas, were included in the retrospective study. The perforations were mainly 1–2 mm in size except for one that was 2.5 × 4 mm. Three patients were treated with PK; one patient was treated with PK and a conjunctival flap; ten patients who had large ulcer areas were treated with PK combined with lamellar keratoplasty (LK). Donor corneas were preserved in sterile pure glycerol at − 80 °C. Corneal grafts were specially edge-trimmed to match the perforation, and then sutured onto the recipient bed avoiding the visual axis.    Results  All 14 patients recovered anatomical integrity without reinfections of the treated eyes. All patients had improved graft transparency and uncorrected visual acuity after surgery. Among them, four patients suffered from short-term postoperative complications and recovered quickly; four patients suffered from long-term postoperative complications, of them, one was performed further treatment.    Conclusion  After individualized PK using glycerol-preserved donor corneas, all perforated corneal ulcers were stably controlled by the end of the follow-up period. This modified surgical technique can be a potential treatment choice for patients with perforated corneal ulcers.

Individualized penetrating keratoplasty using edge-trimmed glycerol-preserved donor corneas for perforated corneal ulcers