Use of an autologous lamellar scleral graft to repair a corneal perforation

Abstract

To report the use of an autologous lamellar scleral graft to close a corneal perforation. Our patient was a 55-year-old female who presented with a paracentral 2 × 2 mm perforation in the center of a preexisting corneal opacity. Because of the unavailability of corneal tissue and the failure to seal the perforation with glue, a partial thickness lamellar scleral graft was harvested from the inferotemporal quadrant and used to close the corneal defect. There was gradual adherence and uptake of the scleral tissue into the surrounding cornea along with significant clearing over the next few months. At 9 months, her best-corrected visual acuity was 20/80 with a stable anterior chamber, focal posterior synechiae and early cataract changes. A band of iris tissue was observed within the lens substance extending posterolaterally from 1 to 7 o’clock positions. In the absence of donor corneal tissue and in selective emergency situations, an autologous scleral patch graft can be considered as a viable alternative in the treatment of full-thickness corneal perforations. We also report the presence of a band of iris tissue within the lens, a finding which has not been previously reported.