A novel surgical technique: “Ab interno” autologous lamellar scleral patch for a large traumatic scleral defect at the posterior pole

Abstract

This case report presents the case of a 60‑year‑old man who underwent autologous lamellar scleral patch graft (SPG) repair for a large posterior pole scleral defect during pars plana vitrectomy (PPV). Initially, the patient experienced a perforating air rifle pellet injury, necessitating suturing of the entry wound. Six days later, lensectomy and PPV were performed for traumatic cataract, removal of an intraocular foreign body, dense vitreous hemorrhage, and retinal detachment. During PPV, a significant full‑thickness scleral defect was found at the posterior pole and repaired using a 3.5 mm × 4.5 mm autologous lamellar SPG sourced from the superotemporal superficial sclera. Postoperatively, the graft fully adhered to the adjacent sclera without complications such as silicone oil leakage or inflammation. This case marks the first instance of utilizing an autologous lamellar SPG for such a large posterior pole defect during PPV, showcasing its effectiveness and safety for such challenging conditions.