ISSN 2398-2942      

Conjunctival graft

icanis
Contributor(s):

Rhea Morgan

Synonym(s): Conjuntival flap


Introduction

  • Surgical technique that utilizes bulbar conjunctiva to close or provide structural support to deep stromal defects of the cornea.
  • Conjunctiva is freed from the episcleral fascia and transposed over the corneal defect.
  • The graft is usually left attached at the base so that a viable blood supply is brought to the cornea.

Uses

  • Deep stromal ulcers and descemetoceles.
  • Corneal perforations and wounds Cornea: laceration, perforation.
  • Following lamellar keratoplasty for the removal of deep stromal neoplasms or other lesions.

Advantages

  • Provides immediate support to a very thin or weak cornea.
  • Introduces a good vascular supply to the lesion.
  • The graft is autogenous, so rejection is not a problem.

Disadvantages

  • Creates an opaque area on the cornea, so may decrease vision if it overlies the pupil.
  • Usually requires a second surgery at a later date to trim the graft.
  • Requires small surgical instruments and suture material.
  • Best performed under magnification, eg head loupe (minimal) or operating microscope (preferred).

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good once the first post-operative week has passed uneventfully.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Glaze M B (1989) Corneal ulceration: medical and surgical managementProc Kal Kan Symposium 13, 103-108.
  • Hakanson N, Lorimer D, Merideth R E (1988) Further comments on conjunctival pedicle grafting in the treatment of corneal ulcers in the dog and catJ Am Anim Hosp Assoc 24 (6), 602-605 VetMedResource.
  • Hakanson N E, Merideth R E (1987) Conjunctival pedicle grafting in the treatment of corneal ulcers in the dog and catJ Am Anim Hosp Assoc 23 (6), 641-648 VetMedResource.
  • Nasisse M P (1985) Canine ulcerative keratitisCompend Contin Educ Pract Vet (9), 686-701 VetMedResource.

Other sources of information

  • Slatter D (2001)Fundamentals of Veterinary Ophthalmology. 3rd Ed. WB Saunders, Philadelphia, pp 303-308.

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