Tectonic Scleral Autograft for Mitomycin C Scleral Fistula

The authors report a surgical procedure for the correction of a scleral fistula in a patient with late hypotony secondary to mitomycin C in a previous deep sclerectomy. A partial-thickness scleral graft using a 2-mm dermatological punch was harvested. Necrotic tissue lining the scleral fistula was excised with the same punch, and the original sclerectomy flap was sutured to the scleral graft. A double conjunctival flap covered the scleral graft. The ptient’s vision improved to 20/40, with an IOP of 10 mm Hg. A functioning bleb was maintained after 18 months’ follow-up.