scholarly journals Conjunctival flap revisited: is it only a temporary solution for difficult corneal diseases?

1970 ◽  
Vol 10 (1) ◽  
pp. 40-45
Author(s):  
MK Sharma ◽  
K Dhakwa ◽  
SKC Rai ◽  
I Kanskai ◽  
AM Bhari ◽  
...  
Keyword(s):  
Herpes Simplex ◽  
Corneal Transplantation ◽  
Complete Healing ◽  
Lamellar Keratoplasty ◽  
Bullous Keratopathy ◽  
Corneal Tissue ◽  
Corneal Ulcers ◽  
Conjunctival Flap ◽  
Neurotrophic Keratitis ◽  
Herpes Simplex Keratitis

Background: The conjunctival flap technique, first described by Gundersen in 1958 has not undergone any major modifications since then, except for some variations depending upon pathology and surgeons’ preferences. Objective: To show the importance of conjunctival (Gundersen) flap in different corneal diseases where keratoplasty is not possible immediately. Methods: Out of total 113 non-healing corneal ulcers of different etiologies, nine patients had undergone total conjunctival flap and the rest of the patients had partial conjunctival flap. Out of 104 partial flaps, 31 patients had bipedicle flap and 73 patients had pedicle conjunctival flap. Diagnoses for Gundersen flap surgery included chronic Non-healing infective keratitis with and without impending perforation(93) (fungal -30, no organisms on culture-42 and bacterial- 21), Neurotrophic keratitis(4),Herpes simplex keratitis(9),Bullous keratopathy(2),Infected nonhealing graft(2),presumed infective perforated keratitis(3)(anterior chamber formed after pad and bandage). Results: Eight flaps retracted due to ulcer necrosis out of which seven cases got perforated with complete healing of ulcer. One case had to be eviscerated due to panophthalmitis. One hundred five cases got cured. Conclusion: Conjunctival flap is the urgent and most reliable remedy (temporary or even permanent in some pathologies) for chronic nonresolving infective and presumed infective keratitis with or without impending perforation, neurotrophic keratitis, chronic herpes simplex keratitis, bullous keratopathy and persistent nonhealing epithelial defects where there are no immediate facilities for corneal transplantation. Conjunctival flap should be familiarized and emphasized as a primary and complementary surgical solution where penetrating keratoplasty or lamellar keratoplasty can’t be immediately performed due to lack of corneal tissue. DOI: http://dx.doi.org/10.3126/hren.v10i1.6006 HREN 2012; 10(1): 40-45

Corneal Higher-order Aberrations and Visual Improvement Following Corneal Transplantation in Treating Herpes Simplex Keratitis

2017 ◽  
Vol 184 ◽  
pp. 1-10 ◽  
Author(s):  
Eisuke Shimizu ◽  
Takefumi Yamaguchi ◽  
Daisuke Tomida ◽  
Yukari Yagi-Yaguchi ◽  
Yoshiyuki Satake ◽  
...  
Keyword(s):  
Herpes Simplex ◽  
Corneal Transplantation ◽  
Higher Order ◽  
Higher Order Aberrations ◽  
Visual Improvement ◽  
Herpes Simplex Keratitis

scholarly journals Corneal transplantation during the COVID-19 pandemic: An operational guide

2021 ◽  
pp. 112067212110065
Author(s):  
Antonella Franch ◽  
Adriano Fasolo ◽  
Paolo Carraro ◽  
Mosè Favarato ◽  
Federica Birattari ◽  
...  
Keyword(s):  
Corneal Transplantation ◽  
Case Series ◽  
Lamellar Keratoplasty ◽  
Corneal Tissue ◽  
Test Results ◽  
Positive Predicted Value ◽  
Case Series Study ◽  
Anterior Lamellar Keratoplasty ◽  
Exposure Risks ◽  
Series Study

Purpose: To provide an operational guide for corneal transplantation during the COVID-19 pandemic aimed to maintain surgery and avoid spreading of SARS-CoV-2. Methods: Prospective observational case series study in patients requiring corneal graft manage toward separate free and restricted pathways for those COVID-19 negative or positive, respectively. Results: During the national lockdown, 30 consecutive patients underwent endothelial ( n = 16), penetrating ( n = 9), and anterior lamellar keratoplasty ( n = 5). Two patients followed the COVID-19 restricted pathway, as they were considered positive while waiting for test results. Nine patients were hospitalized one night in the hospital. On admission to the hospital before surgery, at surgery, the day after surgery and at 7 and 30 days all patients and health-care personnel showed no symptoms and resulted negative at risks factors/exposure to the SARS-CoV-2 infection and occurrence of COVID-19. Nucleic acid testing resulted not detectable in all patients and SARS-CoV-2 antibodies quantification showed IgG and IgM below the positive predicted value in 29 patients. One patient showed IgM above the cut-off of significance (1.21 and 1.03 preoperative and 1-month postoperative, respectively) that were considered irrelevant because of the absence of symptoms and exposure risks. Conclusions: The concept of donor emergency (i.e. short-term availability of transplant tissues), makes corneal transplantation an always-urgent activity because it is related to the availability of the corneal tissue from a donor. Modest adjustments to ophthalmic clinic and eye surgery organization are required to maintain surgery and care of eye patients in a safe environment.

Corneal Transplantation for Herpes Simplex Keratitis

1983 ◽  
Vol 95 (5) ◽  
pp. 645-650 ◽  
Author(s):  
Elisabeth J. Cohen ◽  
Peter R. Laibson ◽  
Juan J. Arentsen
Keyword(s):  
Herpes Simplex ◽  
Corneal Transplantation ◽  
Herpes Simplex Keratitis

scholarly journals Senegalese Experience of Keratoplasties in Public and Private Practice (Aristide le Dantec Hospital and Clinique du Cap), Dakar

2019 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Corneal Transplantation ◽  
Primary Objective ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Small Scale ◽  
Bullous Keratopathy ◽  
Public And Private ◽  
Anterior Lamellar Keratoplasty ◽  
Corneal Transplants ◽  
One Year

Introduction: The corneal surface is exposed to many external aggressions which can alter its transparency and regularity. Several keratoplasty techniques have been codified such as transfixing keratoplasty (KT) or deep anterior lamellar keratoplasty (KLAP) or rotational auto graft. Our work was carried out in Senegal, in a context where corneal transplants were not frequently performed. The aim of our study was to report results one year after a keratoplasty. Patients and Method: We conducted a retrospective study of patients who underwent prior transfixing or lamellar keratoplasty or rotational auto graft. It was carried out between the ophthalmological clinic Aristide Le Dantec hospital and the ophthalmological center of Clinique du Cap in Dakar, Senegal. It included all records of patients with postoperative follow-up greater than or equal to 1 year. The parameters studied were anamnestic data, preoperative clinical examination (indication of corneal transplantation) and postoperative results. Results: Twenty-six eyes of 22 patients were identified. The decrease in visual acuity evolved on average for 5 years. The operative indications were mainly represented by results of pillow type keratitis (30.76%), bullous keratopathy (23.08%), and keratoconus (23.08%). Surgery consisted of a transfixing keratoplasty in 84.61%, lamellar in 15.39% of the cases. Comments: The primary objective of keratoplasty is to restore the transparency, it can also help to remedy pain or improve the anatomical and aesthetic prognosis of the eyeball. The benefits of keratoplasty in our context of developing countries are the reduced cost and shorter waiting time vis-à-vis western countries. Conclusion: The results of our study are encouraging for surgery, still practiced on a small scale in our regions.

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