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. 2022 Feb;42(2):377-383.
doi: 10.1007/s10792-021-01922-x. Epub 2021 Jun 26.

The usability of lamellar scleral autograft in ocular perforation treatment

Umut Karaca  1 , Gulsah Usta  2
Affiliations

The usability of lamellar scleral autograft in ocular perforation treatment

Umut Karaca et al. Int Ophthalmol. 2022 Feb.

Abstract

Importance: Open globe injury is a frequent and preventable healthcare problem with an annual incidence of 3.5/100,000 worldwide. Management and treatment methods aim to ensure globe integrity. Unfortunately, it is not possible to achieve globe integrity in some of the cases, and these can result in poor visual outcomes.

Purpose: To evaluate the usability of lamellar scleral graft in the repair of ocular perforations.

Methods: This was a retrospective review of 11 patients who underwent lamellar scleral graft surgery for ocular perforation between June 2015 and June 2020. Due to the failure of the repairs when other techniques were used, the perforation zones were sealed with lamellar scleral autografts. The primary measures of the outcomes were globe integrity, postoperative best corrected visual acuity, and intraocular pressure (IOP). Visual acuity was determined using the Snellen eye chart, and IOP was measured using the automated pneumatic tonometry during standard examination.

Results: The participants enrolled in this study included 11 patients who underwent lamellar scleral patch graft between 2015 and 2020. The mean age of the patients was 58.81 ± 16.6 years (range, 16-77), and the mean follow-up period was 12.5 ± 3.8 months (range, 8-20). During the surgery, the perforation zone was treated and no leakage was observed. IOP significantly increased, and visual acuity improved in almost all eyes. The factors that made it necessary to use scleral grafts in patients were star-shaped wounds, delayed presentation, lost corneal / scleral tissue.

Conclusion: Lamellar scleral graft is a method that can be used in the treatment of defective ocular perforation with acceptable complications and provides adequate functional and structural stability. Scleral patch grafting can be considered as an alternative option for surgeons treating a variety of ocular conditions that cause tectonic imbalance or poor cosmesis.

Keywords: Lamellar graft; Open globe injury; Scleral autograft; Suturation failure.

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