Long-term prognosis of a new and simple surgical technique for small corneoscleral perforans, using autogenous scleral grafting into a corneoscleral tunnel.
Background: Covering of defects is the only suitable reconstructive method for corneoscleral perforans when the defects are large, but if a defect is small in size, the graft might be too large, and might require suturing to adjacent tissues. However, for small defects, a flap can be grafted into the scleral tunnel with no exposure and steadier fixation. Case : A 70-year-old man had suffered injury to his right eye caused by the nozzle of an air hose. Hyphema, lens luxation, vitreous hemorrhage, and retinal detachment were recognized. As treatment, an intracapsular cataract extraction (ICCE) was done and a vitrectomy was performed twice. Uveal incarceration into the corneosclera under the bulbar conjunctiva was recognized two months after final surgery, and the corneosclera at the site of the incarceration became thinner afterward. Seven years after treatment, the patient complained of ocular pain. Observations : The flap remained alive within few or no vascular tissues during the seven years after surgery. There were no problem such as melt, infection, or pain. Conclusions : This new surgical technique may be very effective and minimally invasive for small corneoscleral perforans.
