| Presentation preference | Oral presentation |
| Title | Corneal Graft: An alternative surgical treatment for necrotising scleritis (NS) and peripheral ulcerative keratitis (PUK) |
| Accept poster if oral is not possible ? | Yes |
| Purpose | To describe three cases of ocular perforation associated with NS and PUK treated with an alternative surgical technique using corneal grafts |
| Methods | This is a retrospective case series study |
| Results | Three patients with ocular perforation associated with NS and PUK. Two male, aged 40-51 years, with GPA and receiving methylprednisolone and cyclophosphamide pulses, VA 20/150 to no light perception. A 19-yo female with no systemic disease identified and receiving prednisone and azathioprine, VA 20/20. All of them underwent corneal grafting to seal the wound and the VA remained unchanged post-surgery. NS and PUK are rare but severe, sight-threatening complications of immune-mediated disorders, most commonly associated with rheumatoid arthritis (RA) and GPA. In cases of severe NS or sclerokeratitis with perforation, despite immunomodulatory therapy, surgical procedures may be required. Potential graft materials include autologous or homologous sclera, fascia lata, periosteum, split-thickness dermis, Gore-Tex (synthetic), and aortic tissue. Extensive conjunctival necrosis is often present, which limits the availability of conjunctiva for graft coverage. Corneal grafting facilitates the reinforcement of weakened areas. As corneal tissue grafting does not require conjunctival coverage, this technique circumvents some of the limitations associated with other grafting methods. |
| Conclusion | Corneal grafting represents a viable option for the treatment of ocular perforation secondary to NS and PUK |
| Conflict of interest | No |
1
| Last name | HIGINO ROCHA |
| Initials of first name(s) | AC |
| Department | Hospital São Geraldo HC UFMG |
| City | Belo Horizonte |
| Country | Brazil |
2
| Last name | Azevedo |
| Initials of first name(s) | DOM |
| Department | Hospital São Geraldo HC UFMG |
| City | Belo Horizonte |
| Country | Brazil |
3
| Last name | Campos |
| Initials of first name(s) | WR |
| Department | Hospital São Geraldo HC UFMG |
| City | Belo Horizonte |
| Country | Brazil |
4
| Last name | Vasconcelos Santos |
| Initials of first name(s) | DV |
| Department | Hospital São Geraldo HC UFMG |
| City | Belo Horizonte |
| Country | Brazil |
