title: Fistula excision and peripheral grafts in the treatment of persistent limbal wound leaks.
abstract: Most small scleral wound leaks at the limbus are treated successfully with suturing, patching, bandage lenses, or cyanoacrylate adhesive, but occasionally a wound leak may continue and a fistula may develop. Although rare, most such fistulas are usually associated with cataract surgery or trauma. Failure of a scleral fistula to close may be due to epithelialization or chronic necrosis of the lumen. In three cases, persistent fistulas of the limbal sclera were excised with a trephine, and a peripheral graft using corneal donor tissue was used to seal the circular defect. This resulted in permanent wound closure and provided a tissue diagnosis of epithelial downgrowth (2 cases) and chronic scleral necrosis (1 case).
authors.affiliation: Department of Ophthalmology, WK Kellogg Eye Center, University of Michigan School of Medicine, Ann Arbor 48105.
authors.forename: H K
authors.initials: HK
authors.lastname: Soong
authors.forename: R F
authors.initials: RF
authors.lastname: Meyer
authors.forename: J R
authors.initials: JR
authors.lastname: Wolter
mesh_terms: D000328:Adult; D000368:Aged; D002387:Cataract Extraction; D016039:Corneal Transplantation; D005123:Eye / Q000473:pathology; D005128:Eye Diseases / Q000209:etiology* / Q000601:surgery; D005131:Eye Injuries / Q000601:surgery*; D005260:Female; D005402:Fistula / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use; D014950:Wounds, Penetrating / Q000601:surgery*
chemical_list: D014014:Tissue Adhesives