J Korean Ophthalmol Soc.  2020 Nov;61(11):1368-1372. 10.3341/jkos.2020.61.11.1368.

Lamellar Corneal Graft Using Acellular Preserved Human Cornea for Perforated Anterior Scleral Staphyloma

• Oh JY
• Lee SH
• Kim KW

• KMID: 2511275
• DOI: http://doi.org/10.3341/jkos.2020.61.11.1368

Abstract

Purpose
To report a case of acquired perforated anterior scleral staphyloma treated successfully by lamellar grafting of the acellular preserved human cornea.
Case summary
A 39-year-old male patient with anterior scleral staphyloma at the superior scleral area near the corneal limbus of the right eye which occurred after congenital cataract surgery visited our hospital due to bleeding and excessive tearing in his right eye. Slit lamp bio-microscopic examination revealed a Seidel-positive perforation with bleeding at the anterior scleral staphyloma. Under general anesthesia, conjunctiva was dissected from the scleral staphyloma. Amniotic membrane (AM) was transplanted over the perforated area and an acellular preserved human cornea (Halo; Eversight Inc., Palo Alto, CA, USA) was grafted over the AM. To aid the vascularization over the grafts, an advancement flap of the adjacent Tenon’s capsule was constructed. Thereafter, the recipient cornea was tattooed for cosmetic purposes. At 4 months postoperatively, the wound had stabilized without perforation recurrence, and staphyloma protrusion had improved.
Conclusions
In a case of a perforated anterior scleral staphyloma, restorative transplantation using acellular preserved human corneal tissue may be a good therapeutic alternative, given that the cornea is easy to suture, is thick enough to compress the protruding area, and has a low risk of graft stretching or melting compared with the sclera.

Keyword

Anterior staphyloma; Lamellar keratoplasty; Preserved cornea