Author/Editor		Gračner, B; Pahor, D; Gračner, T
Title		Ursache und Behandlung einer korneoskleralen Fistel bei 2 Patienten
Translated title		Cause and repair of a corneoscleral fistula in two patients
Type		članek
Source		Ophthalmologe
Vol. and No.		, št. 6
Publication year		2005
Volume		str. 614-7
Language		ger
Abstract		Background. A slowly progressing bulbar hypotension with maculopathy in a male patient as well as an endophthalmitis in a female patient both required surgical repair of posttraumatic leaks. Patients and methods. In a 32-year-old male patient, a filtration bleb leak occurred 4 months after a penetrating stab wound in the corneoscleral region. Persistent bulbar hypotension demanded microsurgical revision, revealing a 1x1 mm scleral defect. The leakage area was close to the limbus. In a 75-year-old female patient, signs of endophthalmitis occurred 4 years after extracapsular cataract extraction with posterior intraocular lens implantation.The place of entry of the inflammation was a 1x3 mm subconjunctival fistula in the corneoscleral scar. In both cases the leakage areas were repaired by an autologous 4x4 mm scleral graft obtained from the pars plana region in the same eye. Results. The postoperative course was without complications, the intraocular pressure was back to normal within a few days in both cases. Two weeks after surgical repair in the first patient, normal ocular fundus and normal visual acuity were observed. In both cases complete and permanent leakage closure was achieved. Conclusions. There are various surgical possibilities for the repair of scleral defects. Patching the defects with autologous scleral grafts has several advantages. Dissection of the graft in the pars plana region is relatively simple. The graft comprising 30% of the scleral thickness is sufficiently firm and supple and there is no danger of infection transmission or of rejection.
Descriptors		CORNEAL DISEASES ENDOPHTHALMITIS MACULAR DEGENERATION OCULAR HYPOTENSION SCLERAL DISEASES FISTULA LIMBUS CORNEAE TREATMENT OUTCOME