Autologous blood-assisted closure of an unanticipated posterior scleral perforation: A novel rescue technique.

The surgical challenge of intraocular foreign bodies (IOFBs) in the posterior pole is compounded by the fact that posterior scleral perforations are often not anticipated preoperatively. We describe a novel, simplified rescue technique using an autologous blood clot to seal a traumatic posterior scleral defect. A 34-year-old male presented with a gunshot injury and a radiopaque IOFB embedded in the posterior sclera. Following pars plana vitrectomy and IOFB removal, a posterior scleral defect was identified. An autologous blood clot was placed over the defect intraoperatively under air to act as a biological seal. Endolaser was applied on and around the clot, and perflouropropane (C3F8) gas was used as a tamponade. Postoperatively, ocular integrity was successfully restored with noted visual improvement. This technique offers a readily available alternative for managing small, unanticipated posterior perforations without the need for complicated suturing of the sclera or donor tissues.