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Homologous scleral graft for corneal perforation in a child
Shmuel Levartovsky1, Amira Springer, Hana Leiba
1Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Israel. levartov@yahoo.com
Insights
Preserved homologous sclera can be an emergency solution for perforated cornea repair in children when donor corneas are unavailable. This technique successfully closed a corneal defect, preserving vision long-term.
Area of Science:
- Ophthalmology
- Regenerative Medicine
Background:
- Corneal perforations in pediatric patients present complex surgical challenges.
- Timely repair is crucial to prevent vision loss and endophthalmitis.
Observation:
- A 3.5-year-old boy experienced corneal perforation during treatment for an acute corneal ulcer and endophthalmitis.
- Standard corneal transplantation was not immediately feasible due to the lack of donor tissue.
Findings:
- A full-thickness preserved donor sclera was utilized to successfully close the 2.5-mm corneal defect.
- Scar tissue formed under the graft, and its removal after 8 months revealed mild opacification.
- Three years post-surgery, the patient achieved a best-corrected visual acuity of 20/60.
Implications:
- Preserved homologous sclera offers a viable alternative for emergency corneal defect closure when donor corneas are scarce.
- This approach can be effective in pediatric cases, potentially preventing further complications and preserving visual function.
Purpose:
To show the emergency use of preserved homologous sclera for the repair of a perforated cornea in a young child.
Methods:
Our case was a 3.5-year-old boy who presented with an acute corneal ulcer and endophthalmitis, which was complicated by a developing corneal melting and perforation of 2.5-mm diameter during pars plana vitrectomy. Because no donor cornea was available, a full-thickness preserved donor sclera was used to close the corneal defect.
Results:
During the next 8 months, scar tissue formed underneath the scleral graft. The graft was removed, revealing mild opacification at the site of corneal perforation. Three years after surgery, best-corrected visual acuity was 20/60.
Conclusions:
In the absence of a corneal button for grafting, preserved homologous sclera may be used for closing a corneal defect.
