Sclerokeratoplasty for the early management of acquired anterior staphyloma

Abstract

Objective: To report a case of acquired anterior staphyloma after trauma and its first surgical management. Methods: This is a case report of a 17-year-old man who had a history of trauma by insect on the right eye, without a previous history of eye conditions, and evolved with local pain and low visual acuity. The ophthalmological exam showed light perception visual acuity in right eye and 1,0 in left eye, anterior staphyloma and impossibility to blink. The first surgical procedure proposed was sclerokeratoplasty and the second one an optical transplantation but, after step one, the patient did not return to the service and missed the follow-up. Results: Sclerokeratoplasty was proposed once the posterior segment and the crystalline were preserved in topical position. The anterior tumor was excised in free-cut and corneal-scleral graft sutured in single points with 10-0 mononylon. Gatifloxacin 0.3% with Prednisolone Acetate 1%, Epitezan® and Atropine 1% were prescribed immediately postoperative. After 60 postoperative days, he maintained the use of Dexamethasone 0.1% and Atropine 1% and the patient had visual acuity of perception of hand movement in the affected eye. Conclusion: Few treatment options are alternatives to evisceration. In this case report, the sclerokeratoplasty was the chosen technique for the initial management. The second step was not possible due to loss of follow-up. Despite the uncomplicated procedure, we need greater compliance by the patient to conclude the treatment.