Authors:Dr. Prabhleen Kochar(Pg Student), Dr. Akshay Bhandari (Asst. Professor), Dr. Waman Chavan (Asso. Professor)

1. COSMETIC CORRECTION OF
ANTERIOR STAPHYLOMA
Authors:
1. Dr. Prabhleen Kochar(PG Student)
2. Dr. Akshay Bhandari (Asst. Professor)
3. Dr. Waman Chavan (Asso. Professor)

2. Introduction
• A staphyloma is a clinical condition characterised by an ectasia of the outer
coats ( cornea or sclera or both ) of the eye with incarceration of the uveal
tissue1
.
• The basic underlying pathology is weakening of the eye ball which can be
caused by many inflammatory or degenerative diseases involving these
structures1
.
• Anterior Staphyloma is an ectasia cicatrix which may be either partial or total3
.
• It occurs due to ectasia of pseudocornea which is a thin fibrous layer formed
by the organisation of the exudates over which conjunctival and corneal
epithelium grows2
.
• The pseudocornea is thin and cannot withstand the intraocular pressure, so it
usually bulges forward along with the plastered iris tissue.

3. Case Report
History:
A 78 year old male patient came to Pravara Rural hospital and
presented with
• loss of vision & abnormal bulging of the left eye since 2 years.
• Pain and discharge in the same eye since 7 days.
Patient gave a history of some unknown foreign body that had
gone into the left eye 2 years back following which he rubbed
his eye in removed the foreign body by himself.
He developed gradual painful loss of vision and bulging of the
left eye ultimately leading to complete loss of vision, 2
months after the incident.

4. Case Report
Examination:
• General & systemic examination of the patient was normal.
• Visual acuity of the patient was 6/12 in right eye and No PL in left eye .
• Right Eye findings were within normal limits.
Local examination of left eye :
• Cornea was bulging forward between the lids
• Exposed portion of conjunctiva was lustreless
• Cornea was opaque, thinned out and ectatic
• Iris tissue was adhered to the back of the cornea in the center
• There was no vascularisation over the cornea .
• Other details could not be appreciated.

5. PREOPERATIVE PICTURES

6. 10/27/16
MANAGEMENT
Clinical diagnosis of Anterior Staphyloma was made and evisceration along
with PMMA implant was carried out under general anaesthesia.
• 360 degrees conjunctival
peritomy done.
• Corneal button removed
along with adhered iris
tissue.
• Intraocular contents
removed using evisceration
scoop leaving behind empty
scleral pocket.

7. 10/27/16
• PMMA ball
• PMMA ball implanted in the
empty scleral pocket.
• Sclera was sutured end to end
followed by conjunctival
suturing covering the scleral

8. 10/27/16
• Patient was started on steroid - antibiotic drops and
antibiotic ointment, anti-inflammatory and
analgesics drugs post operatively and was discharged
after 7 days .
• Patient was sent for customised ocular prosthesis
after 2 months of surgery.

9. 10/27/16
POSTOPERATIVE PICTURES
Customised ocular prosthesis
fixed in the right eye

10. 10/27/16
FINAL OUTCOME
At Presentation After surgical reconstruction with
Customised ocular prosthesis

11. 10/27/16
DISCUSSION
• Anterior staphyloma is not cosmetically acceptable in the
population.
• After evisceration of anterior staphyloma an implant of PMMA
ball was implanted within the scleral pocket to maintain
approximate shape and movement of the globe.
• A customised ocular prosthesis over the well formed sclero
-conjunctival pocket can bring back some amount of movement
with complete cosmetic recovery which apparently appears
normal.
• In this patient, we have tried the above mentioned procedure
with good cosmetic outcome.

12. 10/27/16
REFERENCES
1. Sihota-Tandon. ‘Parson’s diseases of eye’. 22nd
edition 2015 :
229
2. Pramod TK.’ Best Aid to Ophthalmology’ 1st
edition 2013 : 130
3. P.K Mukherji .’Clinical Examination in Ophthalmology’ 1st
edition 2006 : 125