Abstract
Purpose:
To compare the surgical outcome of conjunctival flap (CF) with biodegradable implant (BI, Ologen®) with scleral patch graft, and conventional CF alone for calcified scleromalacia and to confirm the histologic evaluation in rabbit model.
Methods:
In the prospective study, a group of calcified scleromalacia patients received CF with BI (n=5) while other group of the patients was operated with scleral patch graft (n=5), and another group received treatment with conventional method (n=5). The study followed all three groups up for a year to compare the anatomical results using anterior segment optical coherent tomography (OCT) and clinical findings. In animal experiment, CF with BI was operated on an eye of the rabbit while the other eye was treated with conventional CF.
Results:
The patients received BI had lesser inflammation compare to the scleral patch graft group. There also was a complete tissue remodeling on the scleral melting area in the BI group, which resulted better cosmetic effect. The conjunction between conjunctiva and sclera was tight while melting defect was replaced with subconjunctival tissue. In the CF alone group, we prevented the progress of avascular scleral melting, but there was cosmetic problem due to filling defect. In rabbit study, there was complete tissue remodeling on the BI treated side while there remained filling defect on the CF alone side 4 weeks after surgery.
Conclusions:
Biocompatible and biodegradable characteristics of Ologen® enhance the filling effect of scleral defect. CF with BI is an alternative method to treat calcified scleromalacia using on the thin sclera-uveal exposure area after removing calcification for lesser inflammation and better cosmetic results.
Keywords: 708 sclera •
765 wound healing