Autologous scleral button for anterior defect in evisceration surgery
Reviewed by Hetvi Bhatt

This is a small case series of five patients who have had evisceration surgery using a new technique. The anterior defect created when removing the corneal button has been closed by taking an autologous posterior scleral graft inferomedial to the optic nerve using an 8mm punch. This is then sutured to the anterior defect and then tenons and conjunctiva are closed in front as in conventional evisceration surgery. The authors report good motility and cosmesis and have not had any cases of implant exposure so far, although follow-up averaged only 4.2 years (range 1.9–5.6 years) making it difficult to draw conclusions regarding long-term outcomes. The authors do acknowledge small sample size and state that longer follow-up would help determine late enophthalmos and volume deficiency. A comparative study would be useful to determine whether there is a true benefit to using this technique over other more established ones.

Novel use of an autologous scleral button graft to close the anterior defect in evisceration surgery.
Bapty J, Schulz CB, Makuloluwe S, MacLean H.
ORBIT
2023;42(6):579–86.