Case series on scleral patch graft for peripheral corneal perforations

Abstract

Scleral patch grafting is very commonly in use for ophthalmic conditions like scleral melting post pterygium surgery, immune or infection-related scleral melt, localized staphyloma-related scleral thinning, for covering the tubes of Ahmed glaucoma valve implant, for covering the orbital implants post enucleation, etc. A review of literature revealed the use of sclera graft for corneal perforations, but these techniques have become obsolete now due to improvement in eye banking facilities across the country, eye donation awareness leading to easy accessibility to corneal donor tissue. However, under emergency conditions in case of unavailability of corneal donor tissue the technique of scleral patch grafts can be used as a decent alternative to corneal patch grafts. The scleral patch graft is equivalently sturdy and provides tectonic/therapeutic bridging over the perforation to help salvage the eye. In this case series, we have described three cases, two of whom had peripheral corneal perforations due to aggressive corneal ulcerations refractory to medical management. The last case had posterior corneal abscess with thinning which was also refractory to treatment; hence, scleral grafting (unavailability of therapeutic corneal graft) was performed to manage the case.