Internal Plugging of a Traumatic Posterior Perforation Site Using Donor Sclera, Human Amniotic Membrane, and Fibrin Glue: A Novel Surgical Technique

Abstract

Purpose: To describe a novel surgical approach to treat traumatic posterior perforating injuries. Methods: A case and its findings were analyzed. Results: A 21-year-old man presented with bilateral intraocular foreign bodies that were sustained while hammering a metal railway pin. In the left eye, the foreign body was embedded in the posterior scleral wall, resulting in a 2 × 6-mm posterior perforation and partial retinal detachment. Silicone oil tamponade could optimize the chances for retinal reattachment; however, there was concern that the silicone oil would migrate through the posterior defect and into the orbit. Therefore, the perforation site was filled using a 3-layer plug consisting of donor sclera, human amniotic membrane, and fibrin glue. The silicone oil was successfully maintained within the globe; however, the final visual acuity was limited due to proliferative vitreoretinopathy. Conclusions: The efficacy and safety of the 3-layer plug technique should be further validated in similar cases.

From the Editor-in-Chief

“…Valikodath and Vajzovic 10 describe a technique for fluocinolone implant removal using standard cannulas during 3-port pars plana vitrectomy (PPV). Celo et al 11 present a case of internal surgical "plugging" of a large traumatic posterior perforation site (cover). Mishra et al 12 describe the simultaneous repair, including vitrectomy for a bilateral traumatic injury, using co-surgeons to allow overlapping surgical management.…”