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Closure of scleral perforations after trauma is frequently achieved by external suturing. Enlarged perforations towards the equator may require temporary removal of the external ocular muscle to visualise and fix the scleral wound.1 Nakashizuka et al. attached ‘ab interno’ a dislocated intraocular lens by introducing a 10–0 polypropylen loop, held by an intraocular forceps, into the vitreous cavity through a sclerotomy.2 Here, we describe the ‘ab interno’ intravitreal suturing of a large traumatic posterior scleral perforation at the posterior pole.
A 34-year-old patient presented with a paracentral corneal perforation, collapse of the anterior chamber and severe vitreous haemorrhage OD. The patient’s visual acuity was light perception. The patient was treated in a two-step fashion according to Kuhn et al.3 A primary corneal wound closure and placement of a mild scleral buckle was immediately performed, with the application of topical and systemic corticosteroids. The following day, a computed tomography scan was ordered, which showed a …