Scleral Repair by Biodegradable Collagen Implant in Strabismus Surgery

Aim: To evaluate biodegradable collagen implant as a patch for scleral defect.

Case Presentation: A 3 years old girl was subjected to scleral rupture during lateral rectus (LR) advancement for correction of consecutive esotropia. A scleral defect accidentally occurred with uveal exposure of an area 4x6 mm posterior to the original insertion of the lateral rectus muscle The defect was covered by a patch of biodegradable collagen matrix (CM) implant Ologen™ (Aeon Astron Europe B.V., Leiden, The Netherlands) measuring 12 mm diameter x 1mm thickness. Conjunctiva was meticulously closed over it. A follow up of 1 year was performed regarding ocular alignment and globe integrity which was assessed by slit lamp, fundus examination, photography and B-scan ultrasonography (U/S).

Results: Both eyes remained aligned. Scleral defect was well covered, healed by the collagen implant which was incorporated in the surrounding scleral tissues. During postoperative follow up, no uveal exposure and intact retina (no retinal breaks) were detected.

Discussion and Conclusion: Scleral rupture is a potential serious problem that can be managed by patching with collagen matrix biodegradable implant before closing the conjunctiva.