{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T07:40:38Z","timestamp":1767339638732,"version":"3.37.3"},"reference-count":8,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,9,30]],"date-time":"2017-09-30T00:00:00Z","timestamp":1506729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>Corneal burn grade IV usually leads to blindness. Several different surgical techniques remain challenging owing to the extensive tissue damage. Here, we introduce a novel technique with a 15 mm corneoscleral and limbal homologous graft combined with sequential autologous corneal removal ab interno, with a vitrectomy probe to save the anterior chamber angle. In vivo anatomy with optical coherence tomography is the surgical key. A large 15 mm sclerocorneal graft is sutured on top of the remainder of the destroyed cornea and sclera after removal of the epithelium and conjunctiva, with anterior synechiolysis if necessary, peripheral iridectomy and conjunctivoplasty. The recipient central corneal stroma is not removed, primarily to protect the anterior chamber angle. After three weeks, the collagenolytic central recipient corneal stroma can be removed with a small 23 g vitrectomy probe, respecting the lens and scleral spur. The corneoscleral graft remains clear under systemic and local immunosuppression. Intraocular pressure is well controlled because the anterior chamber angle is respected. Recurrent corneal erosions need close follow\u2010up. Therapeutic soft contact lenses can support topical therapy. In cases of sclercorneal graft decompensation or rejection after 3\u20135 years, a new sclerocorneal graft (with limbal donation) seems to be superior to perforating keratoplasty without limbal stem cell transplantation. Repeated sclerocorneal grafts after severe corneal burn with limbal transplantation and maintenance of the complete anterior angle structure are a successful option for preventing blindness and achieving good visual acuity. Clin. Anat. 31:39\u201342, 2018. \u00a9 2017 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ca.22909","type":"journal-article","created":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T23:46:10Z","timestamp":1495583170000},"page":"39-42","source":"Crossref","is-referenced-by-count":12,"title":["Sclerocorneal graft and sequential removal of melted cornea after severe corneal burn with perforation"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7919-4025","authenticated-orcid":false,"given":"Anja","family":"Viestenz","sequence":"first","affiliation":[{"name":"Department of Ophthalmology University Hospital Halle (Saale) Martin\u2010Luther University Halle\u2010Wittenberg Halle Saale Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9701-8204","authenticated-orcid":false,"given":"Berthold","family":"Seitz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Saarland University Medical Centre Homburg\/Saar Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans\u2010Gert","family":"Struck","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital Halle (Saale) Martin\u2010Luther University Halle\u2010Wittenberg Halle Saale Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arne","family":"Viestenz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital Halle (Saale) Martin\u2010Luther University Halle\u2010Wittenberg Halle Saale Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,9,30]]},"reference":[{"key":"e_1_2_4_2_1","first-page":"5","article-title":"Block excision and tectonic corneoscleral graft for recurrent cystic epithelial downgrowth despite alcohol injection: Clinicopathologic report","volume":"5","author":"Al Saraiji H","year":"2017","journal-title":"J Cat Refract Surg Online Case Rep"},{"key":"e_1_2_4_3_1","first-page":"78","article-title":"Epikeratoplasty as an Alternative for Penetrating Keratoplasty?","volume":"210","author":"Bull W","year":"1997","journal-title":"Klin Monbl Augenheilkd"},{"key":"e_1_2_4_4_1","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s00347-015-0133-4","article-title":"Routine keratoplasty?","volume":"113","author":"Fiorentzis M","year":"2016","journal-title":"Ophthalmologe"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1992.01080140079031"},{"key":"e_1_2_4_6_1","first-page":"1","article-title":"A new treatment concept for severe caustic and thermal burns of the eyes","volume":"196","author":"Reim M.","year":"1990","journal-title":"KlinMonblAugenheilkd"},{"key":"e_1_2_4_7_1","first-page":"1244","article-title":"Chemical end thermal eye burns","volume":"233","author":"Struck HG.","year":"2016","journal-title":"Klin Monbl Augenheilkd"},{"key":"e_1_2_4_8_1","first-page":"465","article-title":"Block excision of epithelial ingrowth after cataract surgery\u2013report on 15 patients","volume":"220","author":"Viestenz A","year":"2003","journal-title":"Klin Monbl Augenheilkd"},{"key":"e_1_2_4_9_1","first-page":"429","article-title":"Pain and deterioration of vision following previous lens implantation","volume":"113","author":"Zuche H","year":"2016","journal-title":"Ophthalmologe"}],"container-title":["Clinical Anatomy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fca.22909","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.22909","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T21:52:06Z","timestamp":1694555526000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ca.22909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,30]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1002\/ca.22909"],"URL":"https:\/\/doi.org\/10.1002\/ca.22909","archive":["Portico"],"relation":{},"ISSN":["0897-3806","1098-2353"],"issn-type":[{"type":"print","value":"0897-3806"},{"type":"electronic","value":"1098-2353"}],"subject":[],"published":{"date-parts":[[2017,9,30]]}}}