Clinical Study
Eye (2006) 20, 84–89. doi:10.1038/sj.eye.6701814; published online 1 April 2005
Superior forniceal conjunctival advancement pedicles (SFCAP) in the management of acute and impending corneal perforations
This work was presented as a poster at the Annual Congress of the Royal College of Ophthalmologists, Manchester, 2004.
T Sandinha1, S S Zaher1, F Roberts2, H C Devlin3, B Dhillon3 and K Ramaesh1
- 1Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK
- 2University Department of Pathology, Western Infirmary, Dumbarton Road, Glasgow, UK
- 3Princess Alexandra Eye Pavilion, Royal Infirmary of Edinburgh, Edinburgh, UK
Correspondence: T Sandinha, Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 OYN, UK. Tel: +44 141 211 2034; Fax: +44 211 2054. E-mail: teresa_sandinha@hotmail.com
Received 18 July 2004; Revised 6 November 2004; Accepted 6 November 2004; Published online 1 April 2005.
Abstract
Objective/aim
Corneal perforations can result from a wide variety of disorders and can lead to devastating visual sequelae. Various surgical procedures have been described to manage nontraumatic corneal perforation. Conjunctival flaps offer an important technique in dealing with such corneal emergencies. We report a modified conjunctival flap procedure referred to as superior forniceal conjunctival advancement pedicle (SFCAP) in the successful management of corneal perforation and impending corneal perforation.
Patients and methods
Out of 20 patients who underwent SFCAP for non-traumatic corneal perforation and impending perforation, 16 had corneal perforations. Perforations were secondary to acne rosacea (2), advanced bacterial keratitis (6), corneal anaesthesia(2), multiple retinal procedures (2), previous corneal grafts with a compromised ocular surface (3), and advanced Mooren's ulcer (1).
Results
The globe was preserved in all patients. In 14 of the 16 eyes with perforated corneas the pedicle stabilised. One patient, who was a chronic alcoholic, rubbed the eye during sleep detaching the pedicle a week after surgery. However, the ulcer healed and the integrity of the globe was restored. None of these patients developed secondary glaucoma or ptosis.
Conclusion
SFCAP is an appropriate procedure to manage corneal perforations and impending corneal perforations where donor material is not available and transplantation of such tissue is not suitable.
Keywords:
compromised corneal surface, corneal perforation, conjunctiva surgical flaps
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