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[Defect closure with scleral grafts].

S Kompa1, C Redbrake, O Arend

  • 1Augenklinik, UK Aachen. skompa@gmx.de

Klinische Monatsblatter Fur Augenheilkunde
|October 23, 2004
PubMed
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Scleral patch grafts effectively repaired ocular defects in 85.7% of cases, minimizing rejection through protein denaturation. This method offers a viable solution for complex eye injuries and post-surgical complications.

Area of Science:

  • Ophthalmology
  • Tissue Engineering
  • Surgical Repair

Background:

  • Excessive fistula drainage can necessitate enucleation if primary closure fails.
  • Preserved cadaver tissues (sclera, fascia lata, dura mater, peritoneum) have been used for patch graft repair with variable success.
  • This study investigates clinical outcomes of scleral patch graft transplantation.

Purpose of the Study:

  • To evaluate the efficacy of homologous scleral patch grafts in repairing various ocular defects.
  • To assess the clinical outcomes and complication rates associated with scleral patch graft transplantation.

Main Methods:

  • Surgery involved homologous scleral patch grafts for 28 eyes across 27 patients.
  • Indications included draining fistulas, leaking filtering blebs, scleral perforations, corneo-scleral ulcerations, and post-radiotherapy defects.

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  • Mean graft size was 8.6 x 6.7 mm, with follow-up up to 73 months (median 30 months).

    • Main Results:

    • Functional closure was achieved in 82.1% (23/28 eyes) after initial surgery without complications.
    • Five eyes required surgical revision; two were enucleated due to dehiscence, and two at patient demand due to pain.
    • The fifth revised eye achieved effective closure post-operation.

    Conclusions:

    • Scleral patch grafts successfully closed large corneo-scleral defects in 85.7% (24/28 eyes).
    • Alcohol treatment denatures graft proteins, minimizing antigen load and reducing rejection risk.
    • Scleral patch grafts represent a useful therapeutic option for extensive ocular surface reconstruction.