Limits...
Preserved scleral patch graft for unexpected extreme scleral thinning found at the scleral buckling procedure: a case report.

Stunf S, Lumi X, Drnovšek-Olup B - Indian J Ophthalmol (2011 May-Jun)

Bottom Line: The surgery was converted into a scleral graft procedure, as extreme scleral thinning was found intraoperatively.The anatomical outcome was excellent and the scleral rupture was prevented; the visual outcome was satisfactory.A conversion of the scleral buckling procedure into a scleral graft procedure has proved to be safe and effective for unexpected scleral pathology.

View Article: PubMed Central - PubMed

Affiliation: University Eye Hospital, University Clinical Center Ljubljana, Slovenia, Europe. spela.stunf@siol.net

ABSTRACT
Pre-existing scleral pathology is an important risk factor for globe rupture during scleral buckling procedures. We report here, the surgical management of an unexpected scleral pathology found at the scleral buckling procedure in a retinal detachment patient. A 77-year-old white female with retinal detachment underwent a scleral buckling procedure. The surgery was converted into a scleral graft procedure, as extreme scleral thinning was found intraoperatively. An alcohol-preserved donor sclera graft was used. The second surgery for definitive retinal alignment was performed two weeks later. The presented case of an unexpected scleral pathology in a retinal detachment patient was managed with a combination of scleral grafting and pars plana vitrectomy, without any major complications. The anatomical outcome was excellent and the scleral rupture was prevented; the visual outcome was satisfactory. A conversion of the scleral buckling procedure into a scleral graft procedure has proved to be safe and effective for unexpected scleral pathology.

Show MeSH

Related in: MedlinePlus

Two weeks after the scleral patch graft procedure the scleral graft edge with sutures was exposed during the pars plana approach for vitrectomy (superior temporal quadrant of the globe). The scleral graft was in place with signs of epithelization
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3118011&req=5

Figure 3: Two weeks after the scleral patch graft procedure the scleral graft edge with sutures was exposed during the pars plana approach for vitrectomy (superior temporal quadrant of the globe). The scleral graft was in place with signs of epithelization

Mentions: A combined phacoemulsification with lens implantation and three-port pars plana vitrectomy for definitive retinal alignment was planned a week after the scleral patch graft procedure. However, due to the patient's systemic condition, the second operation had to be delayed for another week. The standard 20G three-port vitrectomy was carried out. The sclera and the scleral graft were exposed [Fig. 2a]. Three sclerotomies were completed 3.5 mm behind the limbus and anterior to the graft, where the sclera was less thin. Repair of the retinal detachment was performed using perfluorocarbon liquid, simultaneous subretinal fluid aspiration, endolaser around the tear, and 360º of the retinal periphery and silicone oil placement. Satisfactory retinal alignment was achieved. The sclerotomies were sutured and the conjunctiva re-approximated at the limbus.


Preserved scleral patch graft for unexpected extreme scleral thinning found at the scleral buckling procedure: a case report.

Stunf S, Lumi X, Drnovšek-Olup B - Indian J Ophthalmol (2011 May-Jun)

Two weeks after the scleral patch graft procedure the scleral graft edge with sutures was exposed during the pars plana approach for vitrectomy (superior temporal quadrant of the globe). The scleral graft was in place with signs of epithelization
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3118011&req=5

Figure 3: Two weeks after the scleral patch graft procedure the scleral graft edge with sutures was exposed during the pars plana approach for vitrectomy (superior temporal quadrant of the globe). The scleral graft was in place with signs of epithelization
Mentions: A combined phacoemulsification with lens implantation and three-port pars plana vitrectomy for definitive retinal alignment was planned a week after the scleral patch graft procedure. However, due to the patient's systemic condition, the second operation had to be delayed for another week. The standard 20G three-port vitrectomy was carried out. The sclera and the scleral graft were exposed [Fig. 2a]. Three sclerotomies were completed 3.5 mm behind the limbus and anterior to the graft, where the sclera was less thin. Repair of the retinal detachment was performed using perfluorocarbon liquid, simultaneous subretinal fluid aspiration, endolaser around the tear, and 360º of the retinal periphery and silicone oil placement. Satisfactory retinal alignment was achieved. The sclerotomies were sutured and the conjunctiva re-approximated at the limbus.

Bottom Line: The surgery was converted into a scleral graft procedure, as extreme scleral thinning was found intraoperatively.The anatomical outcome was excellent and the scleral rupture was prevented; the visual outcome was satisfactory.A conversion of the scleral buckling procedure into a scleral graft procedure has proved to be safe and effective for unexpected scleral pathology.

View Article: PubMed Central - PubMed

Affiliation: University Eye Hospital, University Clinical Center Ljubljana, Slovenia, Europe. spela.stunf@siol.net

ABSTRACT
Pre-existing scleral pathology is an important risk factor for globe rupture during scleral buckling procedures. We report here, the surgical management of an unexpected scleral pathology found at the scleral buckling procedure in a retinal detachment patient. A 77-year-old white female with retinal detachment underwent a scleral buckling procedure. The surgery was converted into a scleral graft procedure, as extreme scleral thinning was found intraoperatively. An alcohol-preserved donor sclera graft was used. The second surgery for definitive retinal alignment was performed two weeks later. The presented case of an unexpected scleral pathology in a retinal detachment patient was managed with a combination of scleral grafting and pars plana vitrectomy, without any major complications. The anatomical outcome was excellent and the scleral rupture was prevented; the visual outcome was satisfactory. A conversion of the scleral buckling procedure into a scleral graft procedure has proved to be safe and effective for unexpected scleral pathology.

Show MeSH
Related in: MedlinePlus