gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Homologues scleral patch grafts in the management of scleral and corneo-scleral defects

Meeting Abstract

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  • corresponding author S. Kompa - University Eye Clinic, UK Aachen, Aachen
  • C. Redbrake - Augenzentrum Alsdorf
  • A. Remky - University Eye Clinic, UK Aachen, Aachen
  • O. Arend - University Eye Clinic, UK Aachen, Aachen; Augenzentrum Alsdorf

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.17.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog155.shtml

Veröffentlicht: 22. September 2004

© 2004 Kompa et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Excessively draining fistulas may lead to enucleation, when primary suture closure is not effective. In these cases preserved cadaver tissues such as sclera, fascia lata, dura mater and peritoneum have been used for patch graft repair with variable results. In this study, clinical outcomes after transplantation of scleral patch grafts have been investigated.

Methods

Twenty-eight eyes of 27 patients underwent surgery with homologues scleral patch grafts for repair of excessively draining scleral fistulas after cataract surgery (n=2), leaking filtering blebs following full-thickness filtration surgery (n=7), large scleral perforations due to trauma (n=7), corneo-scleral ulcerations due to severe eye burns (n=9) or after radiotherapy of malignant melanoma (n=3). The mean size of the rectangular grafts was 8.6 x 6.7 mm (±2.8/3.1 mm). Clinical follow-up was up to 73 months (median 30 months).

Results

Twenty-three of 28 eyes (= 82.1%) showed functional closure after initial surgery without any wound complication such as patch retraction or leakage and without evidence of inflammation. In five eyes surgical revision was necessary. Two of these eyes had to be enucleated due to unrulable dehiscence after the second operation. Two eyes were enucleated on patient's demand.

Conclusions

In our study scleral patch grafts were useful in adequately closing large corneo-scleral defects in 24 of 28 eyes (85.7%). The antigen load and therefore the rejection of the scleral grafts is minimized due to the denaturation of proteins during the alcohol treatment before storage.