Biological encirclage–Traboulsi syndrome

Abstract

Background: Traboulsi syndrome is a sporadic autosomal recessive disorder. Very few cases reported and no surgical treatment has been described. Purpose: The purpose of the study was to describe the surgical treatment of a case of Traboulsi syndrome with intercalary staphyloma. Synopsis: Traboulsi syndrome[1-3] is a type of spontaneous filtering bleb. The case was of a 31-year-old lady with a flat anterior chamber and large intercalary staphyloma, with a subluxated clear lens. Liberal peritomy was done. The staphyloma was cut and the displaced lens was delivered through it. It was closed with 7-0 vicryl continuous suture. A cross-linked cornea was used after removing the Descemet membrane. It was modified to match the crescentic shape of the limbus by using 11 and 6 mm trephine. Two wedge-shaped defects were created and tissue was excised between them, which were then sutured to increase the arc radius. A peripheral flange at the corneal edge was created. A pocket was created in the host cornea to accommodate the donor corneal flange. The donor cornea was tucked in and the graft was sutured. The sclera was used to suture another side prophylactically, making a 360-degree encirclage. The patient got ambulatory vision postsurgery. The use of the cornea as biological encirclage has not been described previously. Highlights: Using a cross-linked cornea. Creating wedge-shaped defects in crescentic corneal graft to increase arc radius. Use of cornea as encirclage. Link of video: https://youtu.be/T3b5rkvFmlc

Keywords

• biological encirclage
• cross-linked cornea
• staphyloma
• traboulsi syndrome
• tuck in keratoplasty