Structural and functional outcome of scleral patch graft

Eye (Lond). 2007 Jul;21(7):930-5. doi: 10.1038/sj.eye.6702344. Epub 2006 Apr 7.


Purpose: To evaluate the visual and structural outcomes of scleral patch grafting in cases of scleral defect.

Methods: The study was a retrospective interventional case series. Medical records of all patients who underwent scleral patch grafting at a tertiary care centre between 1997 and 2003 for scleral defects were reviewed. After removal of all the devitalized tissue, alcohol-preserved full-thickness sclera was tailored to fit the defect and sutured in place. The graft was covered with a conjunctival flap or amniotic membrane. Structural integrity and visual outcome were assessed as the main outcome measures.

Results: A total of 13 eyes of 13 patients required scleral patch grafting for scleral defects of varying aetiologies, the most common being necrotizing scleritis following pterygium surgery (40%). The patients were followed up for 6-60 months, an average period of 24.3 months. Tectonic success was achieved in 10 eyes (76.9%). Three complications were noted: endophthalmitis, graft necrosis, and graft dehiscence with uveal prolapse. However, no regrafts were needed. Epithelialization and vascularization were seen in the remaining eyes after an average duration of 3-4 weeks. Visual acuity remained stable in the majority (9/13, 60%), improved in one and deteriorated in three eyes.

Conclusions: Scleral grafting with overlying conjunctival or amniotic membrane graft is an effective and simple measure for preserving globe integrity both structurally and functionally.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amnion / transplantation
  • Child
  • Conjunctiva / transplantation
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Pterygium / surgery
  • Retrospective Studies
  • Sclera / transplantation*
  • Scleral Diseases / surgery*
  • Scleritis / surgery
  • Treatment Outcome
  • Visual Acuity