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Session Title: Special Cases
Session Date/Time: Friday 14/02/2014 | 08:30-10:00
Paper Time: 09:32
Venue: Kosovel Hall (Level -2)
First Author: : Sang-BummLee SOUTH KOREA
Co Author(s): : Eun-Young Cho Won mo Gu
To introduce a new biodegradable material (Ologen® Collagen Matrix : OCM) for repairing of scleromalacia instead of preserved scleral tissue and to evaluate the long-term outcomes of OCM for ocular surface reconstruction surgery.
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
Two cases of scleromalacia after pterygium excision were included in this study with over than one-year follow-up. A 72-year-old (Case 1) man who developed scleromalacia secondary to excision of pterygium with topical MMC 10 years ago, presented with long standing ocular discomfort. On initial examination, approximately 3 mm progressive scleral excavation with impending uveal exposure was seen in the nasal portion of the left eye. A 70-year-old woman (Case 2) who received pterygium operation with topical MMC in the left eye 6 years ago, complained a decreased visual acuity and ocular discomfort at initial visit. On slit-lamp examination, marked scleral thinning was seen in the nasal portion of the left eye. OCM graft at scleral thinning area was performed with conjunctival limbal autograft (CLAU). OCM was cut by same size of scleral thinning area using biopsy punch and sutured with recipient sclera using 10-0 nylon interrupted sutures. Free conjunctival limbal autograft was harvested with punch biopsy 1mm larger in radius than the piece of OCM. Previous sutured OCM bed was covered with CLAU and the graft was secured with interrupted sutures of 10-0 nylon.
Reepithelialization of the ocular surface was observed within 3~6 days after surgery. All patients experienced loss of ocular pain and inflammation, rapid stabilized ocular surface, and improvement in visual acuity. All of the OCM graft with CLAU remained intact and provided good healthy ocular surface, and recurrence of epithelial defect and scleral thinning was not observed over than a one-year follow-up period in each patient.
When scleral surface defects was present, especially in scleromalacia or scleral necrosis after surgical excision of pterygium, the authors suggested the OCM graft with CLAU is highly recommended for good clinical outcomes and low recurrence rates. With our therapeutic results, new biodegradable material of Ologen® Collagen Matrix qualifies as a new treatment alternative for scleral tissue and amniotic membrane for ocular surface reconstruction. FINANCIAL INTEREST: NONE