title: Corneal Patch Graft: A New Approach for Scleral Necrosis Secondary to Plaque Radiotherapy.
abstract: OBJECTIVE
  To evaluate the anatomical outcomes of corneal patch grafts in patients with progressive scleral necrosis secondary to plaque radiotherapy used for uveal malignant melanoma management.
  
  
  METHODS
  In this case series, 4 patients with progressive scleral necrosis after Ru-106 plaque radiotherapy underwent corneal patch grafts with the anterior corneal button from Descemet stripping automated endothelial keratoplasty donor tissue to strengthen the sclera and to improve appearance of the eye.
  
  
  RESULTS
  Ciliary body involvement was evident in all cases. All 4 patients had received radiation doses of 400 Gy or more to the tumor base. The mean time interval between plaque radiotherapy and scleral necrosis was 24.5 ± 7.5 months (range, 18-34 months). Successful results were achieved in all patients with tectonic graft. No patients experienced graft thinning, rejection, infection, or tumor recurrence in a mean follow-up of 28.5 ± 7.9 months (range, 20-39 months).
  
  
  CONCLUSIONS
  Corneal patch graft by anterior corneal button from Descemet stripping automated endothelial keratoplasty donor tissue results in successful restoration of globe integrity and satisfactory cosmetic appearance in patients with scleral necrosis secondary to plaque radiotherapy.
authors: *Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran; †Department of Ophthalmology, Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA; ‡Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; §Department of Radiation Medicine, Shahid Beheshti University, Tehran, Iran; and ¶Noor Eye Research Center, Noor Eye Hospital, Tehran, Iran.
authors: Masood
authors: M
authors: Naseripour
authors: Hossein
authors: H
authors: Aghaei
authors: Ahad
authors: A
authors: Sedaghat
authors: Ahmad
authors: A
authors: Kheirkhah
authors: Ramin
authors: R
authors: Jaberi
authors: Zohreh
authors: Z
authors: Azma
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D016039:Corneal Transplantation; D058752:Free Tissue Flaps; D006801:Humans; D008545:Melanoma / Q000532:radiotherapy*; D008875:Middle Aged; D009336:Necrosis; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012429:Ruthenium Radioisotopes; D012590:Sclera / Q000473:pathology / Q000528:radiation effects*; D014604:Uveal Neoplasms / Q000532:radiotherapy*; D000098943:Uveal Melanoma
chemical_list: D012429:Ruthenium Radioisotopes