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Jae Chan Kim, Hyun Koo, Jee Taek Kim; Autologous Tragal Perichondrium Transplantation in Refractory Necrotizing Scleritis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6041.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the characteristics of tragal perichondrium tissue as sclera substitutes and report the effectiveness of autologous tragal perichondrium transplantation for refractory necrotizing scleritis.
Histological findings and biomechanical characteristics of fresh human tragal perichondrium, glycerol preserved human sclera, fresh human sclera and preserved pericardium product were compared. Also tissues were cultured and cell compositions were compared. 9 patients with necrotizing scleritis refractory to conventional surgeries including sclera allograft, pericardium allograft, conjunctiva autograft or amniotic membrane graft underwent autologous tragal perichondrium transplantation and closely observed for six months to two years.
Tragal perichondrium showed histological similarities with fresh sclera and had great tensile strength tolerable for higher rupture load than preserved sclera. Also abundant stem cells were cultured from the fresh tragal perichondrium tissue. Scleral defect was successfully reconstructed after autologous tragal perichondrium transplantation on 8 of necrotized scleritis patients. The graft showed rapid epithelization, neovascularization and conjunctivalization. One patient had recurred necrotizing scleritis with graft site melting after 6 months from surgery. There were no other complications have been observed.
Tragal perichondium tissue has similar composition with sclera and shows good biomechanical characteristics for sclera substitutes. And autologous tragal perichondrium graft is an effective treatment to alter necrotized sclera via neovascularization and rapid epithelization in refractory necrotizing scleritis cases.
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