Abstract
The use of patch grafts in the field of ophthalmology has continued to evolve over the last century. Patch grafts are invaluable to reinforce ocular structures, protect implants, facilitate healing, and more. Corneal and scleral tissues, pericardium, dura mater, and amniotic membrane have historically been used as materials for patch grafts. Each material provides its own variation in tensile strength, immunogenicity, resorption, and cosmesis. These variations are important to consider when selecting a graft for a wide variety of conditions, including corneal perforation and melt, scleral melt, and the covering of glaucoma drainage device tubes. The selection of a graft material is also often influenced by the clinical scenario, cost, availability and surgeon preference.
Corneal and scleral grafts have remained a common choice due to their low rejection rates and known structural integrity. Amniotic membrane grafts are notable due to their anti-inflammatory properties and are commonly used in an adjunctive fashion. Tenon’s patch graft is a relatively new option that has gained popularity due to accessibility, affordability, success rates, and lack of rejection due to its autologous nature. Multiple comparative studies have shown no significant difference in exposure rates for donor sclera, cornea, and pericardium when used in glaucoma drainage device surgery.
Biodegradable materials like Ologen (Aeon Astron Leiden,The Netherlands) and synthetic grafts, such as polytetrafluoroethylene, may represent innovative alternatives to traditional tissue grafts. There is now a newer alternative option, CorNeat EverPatch (CorNeat Vision, Ra’anan, Israel. Ongoing evaluations and research are needed to continue evaluating efficacy, accessibility, cosmetic outcomes, complications, and healthcare costs as surgical techniques and material sciences advance over time.