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March 1963

Scleromalacia PerforansA Useful Surgical Modification in Fascia Lata or Scleral Grafting

Author Affiliations

Madison, Wis.; Beirut, Lebanon
From the Department of Surgery (Ophthalmology), University Hospitals, University of Wisconsin and the Veterans Administration Hospital.

Arch Ophthalmol. 1963;69(3):287-289. doi:10.1001/archopht.1963.00960040293003

I. Purpose  The purpose of this paper is to present a modification of an existing surgical procedure for the treatment of a severe case of scleromalacia perforans. To our knowledge this modification has not been previously described.

II. Background  The problem facing us was that of a 40-year-old farmer who presented with a painful right eye with 20/100 vision and a thin, ectatic defect of the temporal bulbar sclera, measuring 9×10 mm., consistent with scleromalacia perforans (Fig. 1).This patient had extensive medical evaluations for possible etiology. No rheumatoid arthritis or other pathology could be definitely diagnosed, although there was a suggestion of histoplasmosis of the lung, by x-ray. On repeated occasions, smears and cultures of the lesion were negative for bacteria and fungus.The eye became steadily more red and painful, and the ectatic area, with blue uveal tissue dramatically showing through, became progressively larger (10×14 mm. preoperatively),

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