Scleral Thinning After Ocular Trauma Covered With Tenon’S Capsule Flap

The aim is to describe a case of a 41-year-old female with scleral thinning due to previous ocular trauma with an agave spine 1.5 years ago.

Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

Department of Ophthalmology, Professor K. Gibinski University Clinical Center, Medical University of Silesia, Katowice, Poland

The patient presented to our outpatient clinic due to progressive scleral thinning in the inferior nasal part of the right eye globe induced by previous trauma with an agave spine. The patient is a professional soldier and was afraid of globe rupture in case of any blunt trauma. The patient did not suffer any discomfort. According to the patient, the translucency of the choroid was enlarging and was more visible with time. Visual acuity, slit lamp examination, colour photo of the anterior segment, and anterior segment optical coherent tomography (AS-OCT, CASIA 2, Tomey) were performed. The patient was referred to the ophthalmology department to place Tennon’s flap onto a thinned sclera with 8-0 Vicryl sutures.

BCDVA was 1.0 in both eyes before and after surgery. IOP was within normal limits in both eyes. Scleral thinning was covered with the patient’s Tenon’s capsule. 2-week follow-up visit revealed Tenon’s tissue attached and completely covering scleral thinning. The patient is scheduled for the next visit in another month.

Scleral thinning is a serious progressive condition which can lead to globe perforation.

Tenon's tissue flaps are easily prepared and do not require additional donor site preparation. Considering the abundant vasculature of this autologous flap, it has a better graft survival rate and a lowered post-operative immune response, negating the need for immunosuppressants.