J Korean Ophthalmol Soc.  2008 Oct;49(10):1706-1710.

Use of Autologous Tenon's Capsule Graft for Repair of Traumatic Scleral Perforation

• Bae JH
• Seong HK
• Kim HK
• Nam WH

Abstract

PURPOSE
To report the use of autologous Tenon's capsule graft for repair of scleral defects caused by traumatic scleral perforation.
CASE SUMMARY
An 81-year-old man presented with loss of vision in his right eye after a perforating injury caused by a cow horn. Examination showed a laceration of the sclera at 12 o'clock approximately 5~6 mm in length, and a uveal tissue was prolapsed into the wound. The best corrected visual acuity was 0.1. Primary repair of the eye was insufficient because of tissue loss. The inferonasal Tenon's capsule graft was carefully dissected from the sclera and tailored to fit the defect. The graft was covered with a conjunctival flap. The scleral defect was successfully closed with the autologous Tenon's capsule graft. Three months after grafting, phacoemulsification with intraocular lens implantation was performed.
CONCLUSIONS
Autologous Tenon's capsule graft is an effective measure to repair traumatic scleral defects and is useful when patch grafts are unexpectedly needed.

Keyword

Autologous Tenon's capsule graft; Scleral perforation; Scleral defect

MeSH Terms

Aged, 80 and over
Animals
Eye
Horns
Humans
Lacerations
Lens Implantation, Intraocular
Phacoemulsification
Sclera
Tenon Capsule
Transplants
Vision, Ocular
Visual Acuity

Figure

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  Figure 1. Preoperative anterior segment photograph of the right eye. It showed diffuse corneal edema and 5~6 mm full-thickness scleral laceration with protruded uveal tissue.

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  Figure 2. Postoperative anterior segment photograph. It showed autologous Tenon’s capsule patch graft (5×4 mm2), which was covered by a conjunctival flap at the superior limbal area.

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  Figure 3. (A) Three weeks postoperative picture. It showed ingrowth of fibrovascular patch over the Tenon’s capsule graft. (B) Six months postoperative picture. It showed successfully survived autologous Tenon’s capsule graft, which was completely covered by the fibrovascular patch.

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  Figure 4. (A) Anterior segment photograph after autograft of Tenon’s capsule. It showed mature cataract. (B) Anterior segment photograph 3 months after phacoemulsification and IOL implantation in the bag.

Reference

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