Download fulltext HTML
1.
Sharma A, Sharma R, S. Nirankari V. Retrocorneal Scleral Patch Supported Glue: A Technique for Management of Corneal Perforation and Corneoscleral Melt following Pterygium Surgery. JOVR [Internet]. 2023Feb.9 [cited 2024May2];18(1):123–129. Available from: https://knepublishing.com/index.php/JOVR/article/view/12732

https://doi.org/10.18502/jovr.v18i1.12732

statistics

  • 401 Abstract Views
  • 272 PDF Views
  • 0 HTML Views

authors

  • Ashok Sharma

    Ashok Sharma

    Ashok Sharma, MS. Cornea Centre, SCO 2463 - 2464, Sector 22C, Chandigarh 160022, India
  • Rajan Sharma

    Rajan Sharma

    Ashok Sharma, MS. Cornea Centre, SCO 2463 - 2464, Sector 22C, Chandigarh 160022, India
  • Verinder S. Nirankari

    Verinder S. Nirankari

    Ashok Sharma, MS. Cornea Centre, SCO 2463 - 2464, Sector 22C, Chandigarh 160022, India

Published Date

  • Feb 9, 2023
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

Retrocorneal Scleral Patch Supported Glue: A Technique for Management of Corneal Perforation and Corneoscleral Melt following Pterygium Surgery

Journal of Ophthalmic and Vision Research (JOVR) / Jan–Mar 2023, Volume 18, Issue 1 / Pages 123–129

Abstract

Purpose: To describe a new method of treatment of corneal perforation with extensive corneoscleral melt.
Case Report: A 42-year-old man presented with moderate-sized (3.5 mm) corneal perforation with extensive corneo-limbo-scleral ulceration following bare sclera excision of pterygium. No prior use of antimetabolites or postoperative beta radiation noted. We considered retrocorneal sclera patch supported cyanoacrylate application. The sclera was thinned to one-third thickness and a patch (4.5×4.5 mm) was punched. The sclera patch was placed on the iris, behind the corneal perforation, adequately covering it from inside. A minimal amount of adhesive was applied on the retrocorneal sclera patch and margin of corneal perforation. The ulcerating sclera was covered with double layered amniotic membrane. Topical antibiotic, steroid, and cycloplegic drops were instilled thrice daily. Corneal perforation healed and no recurrence occurred during the 18 months’ follow-up.
Conclusion: Retrocorneal scleral patch supported cyanoacrylate is effective for corneal perforation with corneo-scleral melt.

Keywords:

Corneal Perforation, Cyanoacrylate Tissue Adhesive, Pterygium Surgery, Scleral Necrosis, Scleral Patch

References
1. Sharma A, Gupta A, Ram J, Gupta A. Low-dose intraoperative mitomycin-C versus conjunctival autograft in primary pterygium surgery: Long term follow-up. Ophthalmic Surg Lasers 2000;31:301–307.

2. Tan DT, Chee SP, Dear KB, Lim AS. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol 1997;115:1235–1240.

3. Alsagoff Z, Tan DT, Chee SP. Necrotising scleritis after bare sclera excision of pterygium. Br J Ophthalmol 2000;84:1050–1052.

4. Ti SE, Tan DT. Tectonic corneal lamellar grafting for severe scleral melting after pterygium surgery. Ophthalmology 2003;110:1126–1136.

5. Siatiri H, Mirzaee-Rad N, Aggarwal S, Kheirkhah A. Combined tenonplasty and scleral graft for refractory pseudomonas scleritis following pterygium removal with mitomycin C application. J Ophthalmic Vis Res 2018;13:200–202.

6. Saini JS, Sharma A, Grewal SP. Chronic corneal perforations. Ophthalmic Surg 1992;23:399–402.

7. Sharma A, Kaur R, Kumar S, Gupta P, Pandav S, Patnaik B, et al. Fibrin glue versus N-butyl-2-cyanoacrylate in corneal perforations. Ophthalmology 2003;110:291–298.

8. Sharma A, Mohan K, Sharma R, Nirankari VS. Scleral patch graft augmented cyanoacrylate tissue adhesive for treatment of moderate-sized noninfectious corneal perforations (3.5–4.5 mm). Cornea 2013;32:1326–1330.

9. Sharma A, Sharma R, Nirankari VS. Intracorneal scleral patch supported cyanoacrylate application for corneal perforations secondary to rheumatoid arthritis. Indian J Ophthalmol 2021;69:69–73.

10. Kitagawa K, Okabe M, Yanagisawa S, Zhang XY, Nikaido T, Hayashi A. Use of a hyperdried cross-linked amniotic membrane as initial therapy for corneal perforations. Jpn J Ophthalmol 2011;55:16–21.

11. Sharma N, Singhal D, Maharana PK, Vajpayee RB. Tuckin tenon patch graft in corneal perforation. Cornea 2019;38:951–954.