Use of an Autologous Lamellar Scleral Graft to Repair a Scleral Melt After Mitomycin Application

Abstract

Mitomycin (MMC) has been associated with a variety of complications, including corneoscleral melt. We report the successful repair of a scleral melt with a partial thickness autologous scleral graft of the scleral melting. A 55-year-old male patient underwent pterygium resection surgery and intraoperative MMC application. The patient developed a deep melting area that almost reached the choroid layer at the nasal sclera. We repaired scleral defect with a partial thickness autologous scleral graft. Closure of an MMC-associated scleral melting area with an autologous partial thickness scleral graft is an effective and easy-to-use method.Electronic supplementary materialThe online version of this article (doi:10.1007/s40123-014-0026-7) contains supplementary material, which is available to authorized users.

Scleral melt and uveal prolapse following 23-gauge pars plana vitrectomy

“… 29 The intraoperative use of MMC can be associated with several postoperative complications, 30 , 31 including scleral calcification, 32 thinning and melting. 33 , 34 The patient's recent exposure to MMC prior to this presentation can work as an additional risk factor. Scleral thinning after pterygium excision was reported following a single application of 0.02% of MMC for 30 seconds, 34 which is shorter than the exposure time for our patient (2 minutes).…”

Scleral defect repair using decellularized porcine sclera in a rabbit model

“…These histological features indicate that when scleral tissue lesions occur, the course of the disease is slow, the tissue repair ability is poor, and the drug treatment effect is not obvious 5 . Once the sclera is damaged due to external factors, such as eye burns and eye surgery, necrosis is difficult to heal and can easily cause scleral perforation 5‐8 …”

“…5 Once the sclera is damaged due to external factors, such as eye burns and eye surgery, necrosis is difficult to heal and can easily cause scleral perforation. [5][6][7][8] Allogeneic scleral grafting has been used in eye surgery for more than 50 years. In 1978, Nersasian 9 used scleral allografts to repair scleral defects and obtained satisfactory results.…”