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Corneal Patch Graft: A New Approach for Scleral Necrosis Secondary to Plaque Radiotherapy
Masood Naseripour1, Hossein Aghaei, Ahad Sedaghat
1*Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran; †Department of Ophthalmology, Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA; ‡Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; §Department of Radiation Medicine, Shahid Beheshti University, Tehran, Iran; and ¶Noor Eye Research Center, Noor Eye Hospital, Tehran, Iran.
Purpose:
To evaluate the anatomical outcomes of corneal patch grafts in patients with progressive scleral necrosis secondary to plaque radiotherapy used for uveal malignant melanoma management.
Methods:
In this case series, 4 patients with progressive scleral necrosis after Ru-106 plaque radiotherapy underwent corneal patch grafts with the anterior corneal button from Descemet stripping automated endothelial keratoplasty donor tissue to strengthen the sclera and to improve appearance of the eye.
Results:
Ciliary body involvement was evident in all cases. All 4 patients had received radiation doses of 400 Gy or more to the tumor base. The mean time interval between plaque radiotherapy and scleral necrosis was 24.5 ± 7.5 months (range, 18-34 months). Successful results were achieved in all patients with tectonic graft. No patients experienced graft thinning, rejection, infection, or tumor recurrence in a mean follow-up of 28.5 ± 7.9 months (range, 20-39 months).
Conclusions:
Corneal patch graft by anterior corneal button from Descemet stripping automated endothelial keratoplasty donor tissue results in successful restoration of globe integrity and satisfactory cosmetic appearance in patients with scleral necrosis secondary to plaque radiotherapy.
