Case 26: Tissue Loss in Open Globe Injuries: A Case of an Open Globe Requiring Corneal Patch Graft

An 83-year-old man with a history of a prior open globe injury of his left eye presents with a concern for a Zone I open globe injury of the same eye after a mechanical fall and subsequent direct strike of his eye on a metal railing in the bathroom. Although the patient understood the poor prognosis, he wanted to try and save his eye. Intraoperatively, the patient’s cornea was found to be too friable for direct closure due to the previous open globe and corneal scarring and a corneal patch graft was required to close the eye. Post-operatively, the patch remained in good position with the structural integrity of the globe intact. Corneal or scleral patch grafts may be needed in the event that there is inadequate healthy tissue for direct closure or in cases of tissue loss. There are several tissue options to use in these cases and it is helpful to be aware of these in case they are needed during the repair.