Posters

Conjunctival pedicle flap in management of open globe injury with corneal tissue loss

Poster Details

First Author: N. Nawani INDIA

Co Author(s):    J. Vazirani   H. Ojha   V. Sangwan              

Abstract Details

Purpose:

We describe the use of conjunctival pedicle flap surgery in the management of traumatic corneal perforation with tissue loss. We highlight an inexpensive and simple surgical technique in the emergency setting, where cyanoacrylate/fibrin glue were not available, in successful restoration ocular integrity and vision.

Setting:

Primary eye care setup in private sector.

Methods:

Accidental injury with scissors led to an open globe injury with iris prolapse and corneal tissue loss in the right eye of a 15-year-old girl. Attempts to suture the laceration normally led to persistent aqueous leak, and tight suturing was leading to unacceptable distortion of the corneal contour. In the absence of donor tissue or tissue glue, a bulbar conjunctival pedicle flap was used to augment sutures placed without undue tension, and watertight closure of the globe was achieved.

Results:

At 10 weeks follow up, on examination, the Snellen visual acuity in the right eye was 6/6 (-0.75 DC x100), the conjunctival pedicle flap had retracted upto the limbus. The eye was uninflamed, an inferior iridectomy was present. There was some scarring at the inferior cornea and limbus, the intraocular pressure was 14mmHg and dilated fundus examination was normal.

Conclusions:

A pedicle conjunctival flap can be a useful option for the corneal surgeon, as an alternative to tissue adhesives such as cyanoacrylate and fibrin glue. An abundance of conjunctival tissue, and the ease of creation of these flaps from almost any site around the cornea can be useful traumatic corneal perforations with tissue loss. This technique is probably best suited to situations where the area of corneal tissue loss from the laceration is adjacent to the limbus.

Financial Disclosure:

NONE