Clinical features and surgical treatment of peripheral staphyloma

To analyze the anatomical features of peripheral staphyloma and evaluate the clinical effects of double lamellar keratoplasty on this eye disease.

Four cases of peripheral staphyloma were treated by double lamellar keratoplasty. One third of the degenerative iris was excised, and the iris was returned into the anterior chamber. Perforation was repaired using a very thin layer of lamellar graft, 1 mm larger than the perforation, after which the anterior chamber was filled with buffered salt solution to check if there was any leak from the graft edge. If there was, the graft was resutured and reexamined. When there was no leak, one more lamellar graft was transplanted to treat the ulcer.

All patients presented a funnel-shaped corneal ulcer with a perforation at the bottom. The iris bulged out from the perforation like a balloon, becoming large with the elevated intraocular pressure. Postoperatively, the anterior chamber returned to its normal structure without anterior synechia. Useful vision was protected, and 3 patients had improved visual acuity.

Peripheral staphyloma has similar morphological and anatomical structures with hernia. Double lamellar keratoplasty, which involves returning the iris into the anterior chamber, repairing the perforation, and transplanting a second lamellar graft, seems to be effective in the treatment of peripheral corneal staphyloma.