title: Scleral patch grafts in the management of uveal and ocular surface tumors.
abstract: OBJECTIVE
  To evaluate the outcome of scleral patch grafts in a series of patients undergoing management for uveal and ocular surface tumors.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Ten patients underwent scleral patch grafting. Five patients had uveal melanoma with extrascleral extension, 2 patients had scleromalacia secondary to plaque radiotherapy for uveal melanoma, 2 patients had suspicious uveoscleral nevi, and 1 patient had invasive conjunctival squamous cell carcinoma with scleral necrosis.
  
  
  METHODS
  Retrospective, interventional, noncomparative chart review of patients undergoing treatment for ocular tumors followed by scleral grafts in a tertiary eye care center in the United States between September 2003 and January 2011. Sclera was reconstructed with allogenic scleral grafts. Clinical observations were performed after grafting.
  
  
  METHODS
  Structural integrity, appearance, and stability of the grafts.
  
  
  RESULTS
  Ten patients were reviewed. All melanoma cases received plaque radiotherapy with palladium 103. The cases with nevi and squamous cell carcinoma underwent local resection with cryotherapy as primary treatment. In 8 cases, scleral grafting was performed as part of the initial surgery. In all of these cases, satisfactory anatomic and functional outcomes were achieved. In 2 cases with scleromalacia secondary to radiotherapy for uveal melanoma, grafts were placed several years after the initial treatment. In these 2 cases, one showed signs of graft retraction, whereas another showed graft thinning. No patients experienced graft infection, rejection, or tumor recurrence.
  
  
  CONCLUSIONS
  In this series, scleral grafts were well accepted when placed as part of the primary tumor management despite synchronous radiotherapy, scleral resection, or cryotherapy. Grafting was less successful when performed as a late procedure for radiation-induced scleromalacia.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: The New York Eye Cancer Center, New York, New York; The New York Eye and Ear Infirmary, New York, New York 10065, USA.
authors.forename: Manabjyoti
authors.initials: M
authors.lastname: Barman
authors.forename: Paul T
authors.initials: PT
authors.lastname: Finger
authors.forename: Tatyana
authors.initials: T
authors.lastname: Milman
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D003230:Conjunctival Neoplasms / Q000473:pathology / Q000601:surgery*; D017679:Cryotherapy; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009508:Nevus, Pigmented / Q000473:pathology / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures; D010165:Palladium / Q000627:therapeutic use; D011832:Radiation Injuries / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D011868:Radioisotopes / Q000627:therapeutic use; D012189:Retrospective Studies; D012590:Sclera / Q000637:transplantation*; D015422:Scleral Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D014184:Transplantation, Homologous; D014604:Uveal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D011868:Radioisotopes; D010165:Palladium