Clinical Experience of Conjunctival Flaps for Persistent Ulcerative Keratitis

ABSTRACT

One hundred and fourteen patients(72 males and 42 females) who received a conjunctival flap for uncontrollable corneal ulcers with medical therapy between June 1983 and October 1994 were studied retrospectively. The range of the patients' ages were 7 to 81 years in which 60s' were popular and the patients were followed up for 15.2 months in average. Major underlying conditions of the patients were microbial infection(40%, 46 eyes) and trauma (25%, 29 eyes). The pathogenic organisms were identified by culture in 35 cases. Gram positive organisms of which staphylococcus species were the commonest were found in 23 cases, while Gram negative organisms of which pseudomonas species were the commonest were found in 11 cases. The location of the corneal ulceration was central(48.2%, 55 cases), paracentral(25.4%, 29 cases), total(19.3%, 22 cases) and marginal(7.0%, 8 cases) in order. The methods of operations were consisted of bipedicle bridge flap(82 cases), total conjuncti val flap(20 cases) and partial conjunctival flap(12 cases) in which 108 cases could be followed up and 96 cases(89%) were healed completely with one operation. As a postoperative complication retraction and displacement (12 cases), melting(10 cases), corneal perforation under the flap(5 cases) and corneal staphyloma (3 cases) etc. were found. Conclusively, the conjunctival flap can be a choice of the procedure for improving corneal wound healing for persistent corneal ulceration recalcitrant to medical therapy.