J Korean Ophthalmol Soc.  2008 Dec;49(12):2006-2010.

A Case of Conjunctival Autotransplantation Using Conjunctival Flap of Pterygium in Treating Corneal Ulcer Perforation

• Jeoung SM
• Im JS
• Park D

Abstract

PURPOSE: To report a case of conjunctival autotransplantation using the conjunctival flap of the pterygium for thetreatment corneal ulcer perforation.
CASE SUMMARY
A 72-year-old woman was referred to our hospital because her left eye had a corneal ulcer due topine needle trauma, and she did not respond to the initial therapy in a private clinic for 1 week. We first applied topical and systemic antibiotics. However, the lesion did not subside, and necrosis progressed in the stroma at the center of the cornea. On day 6 of admission, perforation was found at the center of the cornea, and we excised the necrotic tissue and performed bilateral pedicle conjunctival flap transposition. After the operation, an ischemic change was observed, and in the fourth week perforation occured at the center of the transplanted conjunctival flap. Because we considered it difficult to perform the transplantation of a conjunctival flap in the left eye, we performed autotransplantation on the corneal perforation in the left eye using conjunctival flap obtained through a pterygium excision in the right eye. After the operation, vascular ingrowth started from the edge of the flap, and there were no symptoms of inflammation, shrinkage, or necrosis of the flap. During the follow-up observation, the flap survived well without necrosis.

Keyword

Conjunctival autotransplantation; Corneal ulcer perforation; Pterygium

MeSH Terms

Aged
Anti-Bacterial Agents
Cornea
Corneal Perforation
Corneal Ulcer
Eye
Female
Follow-Up Studies
Humans
Inflammation
Necrosis
Needles
Pterygium
Transplants
Anti-Bacterial Agents

Figure

• 

  Figure 1. Slit lamp photograph showing the corneal opacity with the central epithelial defect on early examination.

• 

  Figure 2. Preoperative photograph shows findings of (A) nasal primary pterygium in the right eye and (B) Corneal ulcer perforation in the left eye.

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  Figure 3. At postoperative 4 days after conjunctival auto- transplantation, (A) the degenerative conjunctiva and fibrovascular tissue had been removed and the surgical wound was healed well in the right eye. (B) Conjunctival autograft with 10-0 nylon was well attached in the left eye.

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  Figure 4. At postoperative 12 weeks after conjunctival autotransplantation, the ocular integrity was maintained well and graft status was stable with good vascularization.

Reference

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