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Ticiana De Francesco,1,2 Tsontcho Ianchulev,3 Douglas J Rhee,4 Ronald C Gentile,3,5 Louis R Pasquale,3 Iqbal Ike K Ahmed1,6,7 1John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2Clinica de Olhos De Francesco, Fortaleza, Brazil; 3Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 4Department of Ophthalmology and Visual Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA; 5NYU Long Island School of Medicine, Department of Ophthalmology, Mineola, NY, USA; 6Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada; 7Prism Eye Institute, Mississauga, CanadaCorrespondence: Ticiana De Francesco, Tel +55 85 32192425, Email ticianadefrancesco@gmail.comAbstract: To review the latest surgical advances and evolving clinical use of scleral bio-tissue for reinforcement in the eye and review the published literature on novel surgical applications of scleral allograft bio-tissue. Conventional surgical procedures for scleral reinforcement using homologous scleral allograft have been traditionally ab-externo interventions comprising of anterior or posterior reinforcement of the sclera for clinical indications such as trauma, scleromalacia, glaucoma drainage device coverage, scleral perforation, buckle repair as well as posterior reinforcement for pathologic myopia and staphyloma. There have been a few novel ab-interno uses of scleral bio-tissue for reinforcement in both retina and glaucoma. Over the last decade, there has been an increase in peer-reviewed publications on scleral reinforcement, reflecting more interest in its clinical applications. With favorable biological and biomechanical properties, scleral allograft may be an ideal substrate for an array of new applications and surgical uses.Keywords: sclera, allograft, biotissue, glaucoma |
