Tarsoconjunctival pedicle flap for the management of a severe scleral melt.
OBJECTIVE
To describe the use of a tarsoconjunctival pedicle flap for the repair of a large scleral melt in a patient with rheumatoid arthritis.


METHODS
Case report and literature review.


RESULTS
A 36-year-old woman with a history of rheumatoid arthritis presented to the Rocky Mountain Lions Eye Institute with a large scleral melt in the right eye. Ophthalmic examination revealed a visual acuity of 20/400 and a superior scleral melt measuring 15 x 30 mm. After instituting systemic immunosuppression, a tarsoconjunctival pedicle was used to provide tectonic support to the globe. At her 3-month postoperative visit, her vision improved to 20/30, and the scleral melt was completely epithelialized.


CONCLUSIONS
A tarsoconjunctival pedicle flap provides an excellent alternative to help restore scleral integrity in patients with severe autoimmune necrotizing scleritis.
Davidson
Richard S
RS
Department of Ophthalmology, Rocky Mountain Lions Eye Institute, University of Colorado School of Medicine, Denver, CO 80041, USA.
Erlanger
Michael
M
Taravella
Michael
M
Gregory
Darren G
DG
Durairaj
Vikram D
VD
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015423:Scleritis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012720:Severity of Illness Index; D013524:Surgical Flaps; D013536:Suture Techniques