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Conjunctival flap viable option for chronic corneal ulcer
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Perforated and non-perforated corneal ulcers that have not responded to medical therapies might respond to a selective pedunculated conjunctival flap, according to a recent report.
Ali Khondadoust, MD, and Ania Porazinski Quinter, MD, retrospectively reviewed all patients who had microsurgical conjunctival flap procedures for chronic corneal ulcers between 1982 and 1996 at the Connecticut Eyecare Center. Postoperative stability of the conjunctival flap and resolution of the corneal ulcer were the primary outcome measures.
Sixty-two percent of the corneal ulcers treated were nonperforated and 38% were perforated. The diagnoses included herpes simplex virus in 14 patients, bacterial ulcer in 11 patients, rheumatoid arthritis in eight patients, aphakic bullous keratopathy in six patients and herpes zoster virus in five patients. Other diagnoses included graft rejection.
Postoperatively, 94% of the conjunctival flaps were stable and 3% had failed. Resolution was definitive in 64% and temporary in 36%. A corneal transplant was performed at 6 to 24 months postop in 61% of patients. In 38%, the flaps were removed 6 to 12 months after the original lesion healed.
The study is published in the August issue of Archives of Ophthalmology.