Homologous scleral graft for corneal perforation in a child

PURPOSE: To show the emergency use of preserved homologous sclera for the repair of a perforated cornea in a young child. METHODS: Our case was a 3.5-year-old boy who presented with an acute corneal ulcer and endophthalmitis, which was complicated by a developing corneal melting and perforation of 2.5-mm diameter during pars plana vitrectomy. Because no donor cornea was available, a full-thickness preserved donor sclera was used to close the corneal defect. RESULTS: During the next 8 months, scar tissue formed underneath the scleral graft. The graft was removed, revealing mild opacification at the site of corneal perforation. Three years after surgery, best-corrected visual acuity was 20/60. CONCLUSIONS: In the absence of a corneal button for grafting, preserved homologous sclera may be used for closing a corneal defect.