The Use of Tutoplast as an Adjunct in Scleral Buckle Procedure in Patients with Extremely Thin Sclera.

Matthew R Starr,Sophie J Bakri

doi:10.18502/jovr.v16i3.9448

Abstract

Extremely thin sclera often necessitates abortion of scleral buckle procedures. In patients in whom a scleral buckle is desired, previous techniques have included the use of cyanoacrylate glue and continuing with surgery or placing donor tissue over the areas of thin sclera, but this can delay surgery. This was a retrospective review of three patients with thin sclera encountered during scleral buckling procedures. All patients had Tutoplast Pericardial Graft placed over the areas of thin sclera which allowed the scleral buckle to be sutured onto the Tutoplast rather than the thin sclera. Tutoplast Pericardial Graft is a useful adjunct in scleral buckle procedures with extremely thin sclera, and a scleral buckle can be safely placed over it and lead to successful retinal reattachment.

Highlights

Encountering thin sclera during retinal detachment surgery can pose a significant problem, when a scleral buckle is to be performed
We present three patients who during retinal detachment surgery were noted to have extremely thin sclera
Tutoplast Pericardial Graft was placed over the areas of thin sclera in order to facilitate the placement of the scleral buckle

Summary

Introduction

Encountering thin sclera during retinal detachment surgery can pose a significant problem, when a scleral buckle is to be performed. Sternberg and colleagues pioneered the use of sutureless scleral buckling in 1988 with the use of cyanoacrylate glue.[1] Previous reports had glued the buckle directly onto the sclera which did not allow the surgeons to adjust the buckle. Sternberg et al described fixing a series of plates with belt loops to the sclera using cyanoacrylate glue with which the buckle could be threaded through and further adjusted. Tutoplast is a dehydrated, processed pericardium from human donor tissue that is converted into a multidirectional, collagen tissue matrix with a thickness of 400 microns.[3] It is meant to use for the repair, replacement, reconstruction, or augmentation of soft tissue.

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