Homologous scleral explant buckles in retinal detachment surgery

Scleral Grafts in Ophthalmic Surgery. A Review

AIM

To summarize the history and current trends in the use of scleral grafts in ophthalmology.

MATERIALS AND METHODS

We conducted a review of the literature through the MEDLINE and Cochrane Library databases. The search terms were "sclera", "graft", and "surgery". The search resulted in 1596 articles, of which we evaluated 192 as relevant. The relevant articles were sorted chronologically and according to the method of using scleral grafts, which enabled the development of a review article.

RESULTS

The sclera has been routinely used in ophthalmology since the 1950s in many different indications. Some of these indications have become practically obsolete over time (for example, use in the surgical management of retinal detachment), but a large number still find application today (especially use in glaucoma or oculoplastic surgery, or as a patch for a defect in the sclera or cornea).

CONCLUSION

Even though allogeneic sclera is currently used less frequently in ophthalmology compared to other tissue banking products and the range of its indications has partially narrowed, it remains a useful material due to its availability and properties.

Scleral homograft inlay for correction of cicatricial entropion and trichiasis

In the management of trachomatous cicatricial entropion and trichiasis numerous surgical options are available to the surgeon, who, however, must choose the correct technique suitable to the severity of the condition. In general, severe cases do better with a graft of mucous membrane or skin. In this paper the use of another graft material, homologous sclera, in correcting entropion and trichiasis is discussed. A 1.5 to 2 mm wide strip of fresh or preserved sclera was used as an inlay in a grey-line split technique with severance of pretarsal and Riolan's fibres in 155 entropion corrections in 136 patients. There was a success rate of 92.3% during the observation period of 15 months. Isolated trichiatic lashes were seen in 7.7%. Minor complications occurred, such as granulomas and partial sloughing of grafts, but did not affect the ultimate results.