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Autogenous lamellar scleral graft in the treatment of scleral melt after pterygium surgery

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Abstract

Background

We report a case series of three patients who developed scleral melting 18–26 months after pterygium removal with β-irradiation that refused to use any donor tissue.

Case series

All patients presented with constant pain, redness and foreign body sensation on their eye.

Results

Initial evaluation revealed the presence of an area of scleral melt and epithelial defect with an underlying calcific plaque over the necrotic area in the nasal conjunctiva. Fluorescein staining and pooling was present at the base of the defect, indicating epithelial loss, in two patients. No signs of infection were present, and screening for associated systemic risk factors for melting was negative in all cases. The patients refused to use any kind of donor tissue to cover the area of melting. An autogenous lamellar scleral graft harvested from the superotemporal quadrant and an advancement of the nasal tenon was used.

Conclusion

The use of autologous sclera and tenon has been described in the treatment of avulsive corneoscleral wounds and corneal fistulas. This case series describes the successful management of scleral melting with autogenous tissues.

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Authors and Affiliations

  1. Department of Ophthalmology, LSU Eye and Neuroscience Center, Louisiana State University Health Sciences Center, 2020 Gravier Street, Suite D, 8th Floor, New Orleans, LA, 70112, USA

    Salomon Esquenazi

  2. Rand Eye Institute, Pompano Beach, FL, USA

    Salomon Esquenazi

Authors
  1. Salomon Esquenazi
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Corresponding author

Correspondence to Salomon Esquenazi.

Additional information

The author does not have any financial interest in any product mentioned in this manuscript. This paper has not been published elsewhere, nor is it being considered for publication elsewhere. This work was supported by P20RR021970 (LSU Translational COBRE Grant) from the National Institute of Health.

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Esquenazi, S. Autogenous lamellar scleral graft in the treatment of scleral melt after pterygium surgery. Graefes Arch Clin Exp Ophthalmol 245, 1869–1871 (2007). https://doi.org/10.1007/s00417-007-0693-3

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  • DOI: https://doi.org/10.1007/s00417-007-0693-3

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