Original Article
Conjunctival flap cover surgery: 10-year review
Abstract
Background: To evaluate the conjunctival flap cover surgery for the treatment of ocular surface disorders.
Methods: Retrospective uncontrolled study was performed. A total of 253 eyes of 253 patients who had received conjunctival flap cover surgery during a 10-year period were included. The indications, symptoms and complications experienced by patients undergoing partial or total conjunctival flap cover surgery were reviewed.
Results: In all of these cases, satisfactory anatomic and functional outcomes were achieved. The BCVA of 224 eyes out of 253 patients (88.5%) were no worse than that of preoperative and the BCVA of 29 eyes out of 253 patients (11.5%) decreased postoperatively. No eye pain, foreign body sensation and other discomforts presented in the last visit. The surgical indications was therapeutic for 138 out of 253 patients (54.5%), aesthetic for 63 eyes out of 253 patients (24.9%), tectonic for 45 eyes out of 253 patients (17.8%), and analgesic for 7 eyes out of 253 patients (2.8%). The primary diagnose of therapeutic indications is refractory corneal ulcer for 135 eyes out of 253 patients (53.4%). The main diagnose of aesthetic indications is atrophy of eyeball for 45 eyes out of 253 patients (17.8%) and corneal leukoma for 18 eyes out of 253 patients (7.1%). The principal diagnose of tectonic indications is corneal perforation for 43 eyes out of 253 patients (17%). The main intraoperative complications is buttonhole formation for 8 eyes out of 253 patients (3.2%), which can be handled by simple suture. The most severe complications postoperatively was conjunctival flaps dissolving and corneal perforation for 3 eyes out of 253 patients (1.2%), and corneal transplantation had to be performed to avoid enucleation. In addition, 4 eyes out of 253 patients (1.6%) presented cystic flap and two of them received surgical excision.
Conclusions: Conjunctival flap cover surgery is an underused technique. Its primary indication is refractory corneal ulcer and corneal perforation, and its second indication is aesthetic with poor visual potential coexisting ocular surface diseases. It represents an interesting alternative to more mutilating surgeries.
Methods: Retrospective uncontrolled study was performed. A total of 253 eyes of 253 patients who had received conjunctival flap cover surgery during a 10-year period were included. The indications, symptoms and complications experienced by patients undergoing partial or total conjunctival flap cover surgery were reviewed.
Results: In all of these cases, satisfactory anatomic and functional outcomes were achieved. The BCVA of 224 eyes out of 253 patients (88.5%) were no worse than that of preoperative and the BCVA of 29 eyes out of 253 patients (11.5%) decreased postoperatively. No eye pain, foreign body sensation and other discomforts presented in the last visit. The surgical indications was therapeutic for 138 out of 253 patients (54.5%), aesthetic for 63 eyes out of 253 patients (24.9%), tectonic for 45 eyes out of 253 patients (17.8%), and analgesic for 7 eyes out of 253 patients (2.8%). The primary diagnose of therapeutic indications is refractory corneal ulcer for 135 eyes out of 253 patients (53.4%). The main diagnose of aesthetic indications is atrophy of eyeball for 45 eyes out of 253 patients (17.8%) and corneal leukoma for 18 eyes out of 253 patients (7.1%). The principal diagnose of tectonic indications is corneal perforation for 43 eyes out of 253 patients (17%). The main intraoperative complications is buttonhole formation for 8 eyes out of 253 patients (3.2%), which can be handled by simple suture. The most severe complications postoperatively was conjunctival flaps dissolving and corneal perforation for 3 eyes out of 253 patients (1.2%), and corneal transplantation had to be performed to avoid enucleation. In addition, 4 eyes out of 253 patients (1.6%) presented cystic flap and two of them received surgical excision.
Conclusions: Conjunctival flap cover surgery is an underused technique. Its primary indication is refractory corneal ulcer and corneal perforation, and its second indication is aesthetic with poor visual potential coexisting ocular surface diseases. It represents an interesting alternative to more mutilating surgeries.
