To describe a surgical technique for salvaging recurrent exposure of scleral buckle.
A patient, treated for rhegmatogenous retinal detachment with scleral buckle, presented with exposed uninfected buckle 3 weeks after the initial surgery. We tried to cover the exposure twice with conjunctivoplasty and once with scleral patch graft with amniotic membrane transplantation, but each one of them failed. After these failed attempts, we harvested autologous periosteal patch graft from the retroauricular area, which was sutured over the exposed buckle along with conjunctivoplasty.
Autologous periosteal patch graft was successful in our case and reepithelialization was completed within 4 weeks. A small granuloma was formed at the suture site at the fifth week, which resolved completely with topical steroids. The conjunctiva and periosteal patch have remained stable over a follow-up period of 1 year. The autologous periosteal patch graft permanently covered the defect with complete reepithelialization by 4 weeks after the surgical procedure.
Autologous periosteal patch graft can be offered as a viable alternative option to the patients with scleral buckle exposure.
Autologous periosteal patch graft harvested from the retroauricular area can be offered as viable alternative in cases of exposed scleral buckles in addition to other existing options. It offers high success rate with a reduced risk of transmission of viral and other infectious agents apart from immunogenic rejections.
Retina Clinic, Vasan Eye Care Hospital, New Delhi, India.
Reprint requests: Shashank R. Gupta, MS, Vasan Eye Care Hospital, Parvetesh Towers, 36B Pusa Road, Opposite Metro Pillar 125, New Delhi 110060, India; e-mail: email@example.com
None of the authors have any financial/conflicting interests to disclose.