Prasher Pawan
Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab, India,
Int Ophthalmol. 2014 Aug;34(4):957-60. doi: 10.1007/s10792-013-9883-7. Epub 2013 Dec 11.
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.
报告使用自体板层巩膜移植片闭合角膜穿孔的情况。我们的患者是一名55岁女性，在先前存在的角膜混浊中央出现一个2×2mm的旁中央穿孔。由于无法获得角膜组织且用胶水未能封闭穿孔，从颞下象限获取一块部分厚度的板层巩膜移植片，用于闭合角膜缺损。在接下来的几个月里，巩膜组织逐渐粘连并融入周围角膜，同时角膜显著清亮。9个月时，她的最佳矫正视力为20/80，前房稳定，有局限性虹膜后粘连和早期白内障改变。在晶状体实质内观察到一条虹膜组织带，从1点至7点位置向后外侧延伸。在缺乏供体角膜组织且处于选择性紧急情况下，自体巩膜补片移植可被视为治疗全层角膜穿孔的一种可行替代方法。我们还报告了晶状体内存在一条虹膜组织带，这一发现此前未见报道。
