Successful Application of Buccal Mucosal Graft Transplant in Resistant Suture Exposure of Transscleral-Sutured Posterior Chamber Intraocular Lens

We report the successful reconstruction of suture exposure with the oral mucosal graft in a patient with suture exposure after transscleral-sutured posterior chamber intraocular lens implantation. The 70-year-old patient had a history of vitreoretinal surgery and transscleral-sutured posterior chamber intraocular lens implantation after complicated cataract surgery. He was referred to our department because of suture exposure. The best-corrected visual acuity was 20/2000 OD and 20/50 OS. We observed exposed PC9 sutures from both the nasal and temporal conjunctiva in the right eye. The patient showed appearance of scleromalacia in the same regions, so scleral flap surgery was not considered. Despite both tenoplasty and amniotic membrane transplant procedures, exposure could not be controlled. Instead, the patient received oral (buccal) mucosal graft transplant to the resistant exposure areas. A single layer of protective amniotic membrane was transplanted over the buccal mucosal graft. This method resulted in effective control of the exposed area. In conclusion, an oral mucosal graft can be used in many ocular pathologies that require conjunctival reconstruction because of the simplicity of tissue excision from the mucosa, allowing adequate tissue excision, durability of the obtained tissue, and ease of use. Our case report highlights that resistant transscleral-sutured posterior chamber intraocular lens suture exposure can be successfully managed with oral mucosal grafting.