Year : 2016  |  Volume : 24  |  Issue : 2  |  Page : 80-83

Management of perforated mooren's ulcer with a rotational scleral autograft in Abuja

Department of Ophthalmic Surgery, College of Health Sciences, Bingham University, Jos, Nigeria

Correspondence Address:
Prof. Olufemi Emmanuel Babalola
Rachel Eye Center, 23, Onitsha Crescent, Garki, Abuja
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0189-9171.195203

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Mooren's ulcer is a fairly common peripheral corneal melting disease in Nigeria. Cases presenting late with perforation and uveal prolapse are a serious challenge to management, particularly in a setting where corneal grafting is not routinely practiced. To describe the management of perforated Mooren's ulcer using scleral rotational autograft. A case of bilateral Mooren's ulcer with corneal melting and uveal prolapse in the left eye (LE) involving 1½ h was managed with a scleral rotational autograft at the Rachel Eye Center, Abuja. The patient was a 75-year-old female retiree with concomitant rheumatoid arthritis involving the knee and metacarpophalangeal joints. Following a 360° peritomy and cryotherapy in both eyes, a partial thickness scleral hinged autograft was developed and rotated over the uveal prolapse and corneal defect whereupon, it was fastened with interrupted 10/0 nylon sutures and secured with a bandage soft contact lens. The integrity of the globe was maintained for over 6 months with the scleral flap which became largely transparent from the 13th day after the surgery. The anterior chamber went flat temporarily, but this was reversed with firm pad over a contact lens. This technique is recommended as at least a stopgap before the availability of corneal grafts.

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