Dermal graft. Alternative to Gunderson flap allows fitting scleral shell over sensitive cornea.
Corneal discomfort often prevents the successful wearing of a cosmetic scleral shell. Such sensitive corneas are traditionally covered with a Gunderson conjunctival flap. I describe two patients in whom preexisting severe conjunctival scarring precluded the possibility of developing a Gunderson flap. An alternative procedure in which autogenous split-thickness dermal grafts were sutured over the sensitive cornea was utilized in each patient. The dermal grafts reepithelialized with mucosa within 4 weeks, and both patients were then able to retain an ocular prosthesis without discomfort. I conclude that satisfactory corneal coverage may be obtained with a dermal graft when conjunctival scarring precludes the use of a Gunderson flap.
Khan
J A
JA
Department of Ophthalmology, Kansas University Medical Center, Kansas City 66103.
D000328:Adult; D001766:Blindness / Q000209:etiology; D003315:Cornea / Q000601:surgery*; D005123:Eye / Q000473:pathology; D005131:Eye Injuries / Q000150:complications / Q000473:pathology; D005137:Eye, Artificial; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D016038:Skin Transplantation