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Chapter-069 Conjunctival Flaps

BOOK TITLE: Copeland and Afshari's Principles and Practice of Cornea (2 Volumes)

Author
1. Steiner Anne S
2. Udell Ira J
ISBN
9789350901724
DOI
10.5005/jp/books/11777_69
Edition
1/e
Publishing Year
2013
Pages
5
Author Affiliations
1. North Shore-Long Island Jewish Ocular Surface Center; Hofstra North Shore—LIJ School of Medicine, New York, New York, USA, North Shore-Long Island Jewish Ocular Surface Center; Hofstra North Shore— LIJ School of Medicine, New York, New York, USA, Hofstra North Shore—LIJ School of Medicine, New York, New York, USA, Hofstra North Shore— LIJ School of Medicine, New York, New York, USA
2. Hofstra North Shore-Long Island Jewish, School of Medicine; North Shore-Long Island Jewish Health System, Great Neck, New York, USA, Hofstra North Shore-Long Island Jewish, School of Medicine; North Shore-Long Island, Jewish Health System, Great Neck, New York, USA, North Shore-Long Island Jewish Health System, Great Neck, New York, USA, North Shore-Long Island, Jewish Health System, Great Neck, New York, USA
Chapter keywords
Conjunctival flaps, nonhealing epithelial defects, recalcitrant microbial keratitis, peripheral corneal disease, total conjunctival flap, partial conjunctival flap, retrobulbar injection, flap retraction, hemorrhage, epithelial inclusion cyst

Abstract

Conjunctival flaps are commonly employed for the treatment of recalcitrant ocular surface diseases. This chapter describes the current indications for conjunctival flaps, as well as the various techniques for this procedure and its possible complications. The indications for conjunctival flap include blind and painful eye, nonhealing epithelial defects, recalcitrant microbial keratitis, corneal descemetocele and perforation and peripheral corneal disease. The main disadvantages of conjunctival flap while evaluating a patient include inability to monitor intraocular pressure and ocular pathology, limited view of the cornea and decreased visual acuity when the conjunctival flap covers the visual axis. The conjunctival flap procedure is generally performed with retrobulbar or peribulbar injection of anesthesia and total conjunctival flap is commonly used technique. The complications associated with conjunctival flap include buttonholes, flap retraction, hemorrhage, epithelial inclusion cyst and ptosis. These complications of conjunctival flap can be avoided with meticulous preoperative planning and surgical technique.

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