Allogenic Scleral Patch Grafting For Post-Surgical Scleral Defect :Structural And Visual Rehabilitation

To highlight the importance of early tectonic intervention in managing large scleral defects after anterior segment surgery and to demonstrate the structural and visual outcomes achieved with allogenic scleral patch grafting. Scleral defects can result in globe instability, irregular astigmatism, inflammation, and increased susceptibility to endophthalmitis. This case underscores the role of prompt surgical reconstruction in preventing long-term morbidity and restoring functional vision.

Tertiary referral eye care center in India managing complex anterior segment complications and ocular surface reconstruction.

A 70-year-old male presented with severe visual impairment and structural deformity of the right eye following conjunctival cyst excision complicated by a 6×3 mm scleral defect located 2 mm posterior to the limbus. BCVA was perception of light with accurate projection. Slit-lamp evaluation revealed subconjunctival hemorrhage, corneal haze, hyphema and a posterior chamber intraocular lens in situ. Under local anesthesia, prior sutures were removed and wound exploration performed. A size-matched donor scleral patch graft was secured using interrupted 6-0 polyglactin sutures and covered with a conjunctival flap. Postoperative topical antibiotic-steroid therapy was administered and tapered.

Anatomical integrity of the globe was successfully restored. The postoperative course was uneventful with stable graft integration and healthy conjunctival coverage. Progressive resolution of anterior segment inflammation was noted. At 4-month follow-up, best corrected visual acuity improved markedly to 6/9 (partial). Structural contour was re-established with significant functional and cosmetic improvement.

Allogenic scleral patch grafting is a safe, reproducible, and effective technique for managing large scleral defects. Beyond tectonic reinforcement, it facilitates visual rehabilitation by restoring scleral contour and reducing induced irregularity. Early recognition and definitive surgical repair are critical in preventing infectious complications and irreversible visual loss. This case reinforces scleral patch grafting as a valuable tool in anterior segment reconstructive surgery.