Application of conjunctival flap covering surgery in treatment of refractory corneal ulcer

Objective To discuss the clinical effect of conjunctival flap covering surgery in treatment of refractory corneal ulcer.Methods Twenty-two patients with refractory corneal ulcer were chosen,including 4 cases with herpes simplex virus corneal ulcer,7 cases with fungal corneal ulcer(2 cases with corneal perforation),8 cases with bacterial corneal ulcer,1 case with serious chemical burn,2 cases with corneal graft ulcer after penetration keratoplasty.All patients received the focus lesion clearance and conjunctival flap covering surgery,and the symptom was treated according to the primary disease.The follow-up time was from 3 months to 6 months,the visual acuity,anterior chamber and blood supply of conjunctival flap were observed.Results Twenty patients were cured after the primary treatment,the corneal flap dissolved and separated in 2 cases,in which 1 case with bacterial corneal ulcer was cured after re-conjunctival flap covering surgery,the other case received the 2 times conjunctival flap covering surgery,but the infection was not controlled,eventually conjunctival flap autolysis occurred.The visual acuity in 21 cases was unchanged or improved,in which 5 cases with light perception,from finger counting to 0.1 in 12 eyes,from 0.2 to 0.5 in 5 eyes.The anterior chambers were formed in 21 cases,the intraocular pressure was ordinary normal.Conclusion In the condition of proper selecting the appropriate indications and carefully operating,the conjunctival flap covering technique is one of the effective methods for treating the refractory corneal ulcer.