Non-vascularized scleral ischemia can cause progressive necrosis and melting. If the common graft materials used for scleral necrosis—preserved donor sclera and amniotic membranes—do not provide an adequate job, researchers in South Korea have found great success transplanting stem cell–containing perichondrium tissue and amniotic membrane on the avascular sclera. The autologous perichondrium patch and membrane grafts proved to be an effective method for restoring scleral integrity and vascularization of the episclera and conjunctiva in eyes with progressive scleral necrosis.

The study found successful structural integrity in 17 out of the 18 cases (94.4%) at six months post-surgery. Scleral necrosis healed completely after transplantation, even in cases with full-thickness scleral defect. Scleral integrity was maintained all the way up to the study’s last follow-up session, which ranged from two years to 80 months after the procedure. The study found no serious complications of endophthalmitis or graft infection.

Researchers attribute the potent therapeutic potential to the mesenchymal stem cells and their niches in the perichondrium. They suggest the tissue to be a physiologically appropriate graft material for scleral reconstructive surgery.

Kim JT, Kim KW, Mun SK, et al. Transplantation of autologous perichondrium with amniotic membrane for progressive scleral necrosis. Ocul Surf. May 18, 2019. [Epub ahead of print].