Sir,
I read with interest the article written by T Sandinha et al.1 I would like to make the following comments.
In the case 1 reported, the conjunctival pedicle appears very vascular even though the initial surgery was performed 2 months ago. The peripheral cornea was vascularised in the corresponding quadrant, contrary to what the authors had claimed in their article. This amount of peripheral corneal vascularisation would work against the success of any future corneal transplant surgery. An amniotic membrane graft or a tectonic corneal graft would have been a better choice for such a corneal perforation involving the visual axis. In the event of nonavailability of donor material, temporary glueing of the perforation or even a scleral autograft could have been carried out.
However, I agree that Superior forniceal conjunctival advancement pedicles could be used in peripheral corneal perforations such as the case 2 described in the article.
References
Sandinha T, Zaher SS, Roberts F, Devlin HC, Dhillon B, Ramesh K . Superior forniceal conjunctival advancement pedicles (SFCAP) in the management of acute and impending corneal perforations. Eye 2006; 20: 84–89.
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Ilango, B. Reply to T Sandinha et al. Eye 20, 1468 (2006). https://doi.org/10.1038/sj.eye.6702354
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DOI: https://doi.org/10.1038/sj.eye.6702354