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    A Novel Repair in Treatment of Scleral Melt

    7th Annual Global Video Contest
    Cornea/External Disease

    We present a case of a 54-year-old female with a history of a scleritis leading to scleral melt secondary to Granulomatosis with Polyangiitis, previously treated with a traditional scleral patch graft 3 years earlier. The patient was referred urgently for assessment after suffering a recurrence of her scleral melt through the original scleral patch graft at the same site. Given the failure of the prior patch graft, a novel technique was employed to repair the area of melt. A complex consisting of sclera, partial thickness cornea, and amniotic membrane was utilized. This novel technique ensures enhanced reinforcement, while avoiding an unwanted thick patch graft complex. In addition to surgical treatment, our patient has been co-managed with the rheumatology service, having previously been treated with IV solumedrol during acute flares followed but a taper of oral prednisone. She was also treated with three rounds of cyclophosphamide, while transitioning to long-term immunomodulatory therapy. Presently, our patient is stable on low dose oral prednisone, Imuran and Rituximab Infusions (every 6 months as needed).