Scleral Graft, Free Conjunctival Autograft Using Tissue Adhesive and Temporary Amniotic Membrane Transplantation in Scleromalacia

ABSTRACT

PURPOSE: To evaluate the surgical results and complications arising from scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation as the surgical treatment for scleromalacia. METHODS: Scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation was performed in 20 eyes of 20 patients with scleromalacia caused by pterygium excision. The surgical results and complications arising from the procedure were monitored and analyzed through follow-up. RESULTS: During the follow-up period of 17.6 +/- 5.9 months, the wound injection and edema at the free conjunctival autograft and operation site healed in all the cases except 1 at postoperative 1 month. The stability of the ocular surface for graft transplantation was maintained at postoperative 3 months. Although a partial absorption of the conjunctival autograft induced by careless treatment occurred 2 weeks postoperative in 1 case, the ocular surface stabilized due to suitable treatment after 6 months. Although the edges of the scleral graft in 3 patients were partially absorbed 6 months postoperatively, the ocular surface stability was maintained by covering the conjunctival autografts. CONCLUSIONS: For scleromalacia patients, scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation rapidly stabilized the ocular surface and presented excellent aesthetic results.