Scleral Patch Autograft In Managing Scleral Defect After Iol Scleral Fixation

To report two cases of scleral defect following scleral-fixated intraocular lens (IOL) implantation, managed with scleral patch autografts.

Ophthamology department, Habib Thameur University Hospital, Tunis, Tunisia

The medical records of the two patients were retrospectively reviewed. The first patient was a 9-year-old boy with a history of homocystinuria, and the second one was an 18-year-old
female with a history of Marfan syndrome. Both patients underwent surgery for ectopia lentis with scleral fixation of an IOL using 6.0 mersilene suture in their right eyes.

They presented with chronic conjunctival inflammation and erosion due to unburied knot. Scleral thinning with progressive IOL dislocation were noted. Surgical management involved the explantation of the dislocated IOLs through a corneoscleral tunnel and the implantation of retropupillary iris-claw IOLs. To manage the scleral defect a square partial-thickness scleral patch was fashioned to the appropriate size from the inferior sclera and was sutured using 10.0 nylon to cover the scleral defect. The graft was covered by the adjacent conjunctiva. There were no signs of inflammation, and the scleral grafts remained in place at one-month follow-up in both patients. For the first case, anatomical results were stable for up to one-year follow-up.

The use of an autologous scleral patch graft is a good option in complex situations involving scleral defects. The absence of inflammation observed during the follow-ups highlights its
reliability as a viable surgical approach in such cases.