The Use of Conjunctival Pedicle Flaps to Prevent Corneal Perforation in Graft-Versus-Host Disease.
OBJECTIVE
We report the clinical outcomes of two chronic graft-versus-host disease (cGVHD) corneal thinning cases that were successfully treated with conjunctival pedicle flaps in an effort to prevent impending corneal perforation.


METHODS
The patients were treated with topical and systemic corticosteroids, therapeutic contact lenses, lubricants, and punctual plugs. Conjunctival pedicle flaps were used because conventional treatments had failed, and corneal perforation was imminent.


RESULTS
Both patients were successfully treated with conjunctival pedicle flaps. Following conjunctival flap removal, one patient had corneal clarity restored following penetrating keratoplasty.


CONCLUSIONS
Conjunctival pedicle flaps provided a strong barrier for the corneal surface and stabilized anterior chamber in cGVHD patients with impending corneal perforation following allogeneic hematopoietic stem cell transplant.
a Department of Ophthalmology , Yeouido St. Mary's Hospital, The Catholic University of Korea , Seoul , Korea.
Min-Ho
MH
Kim
b Department of Ophthalmology and Visual Science , Seoul St. Mary's Hospital, The Catholic University of Korea , Seoul , Korea.
So-Hyang
SH
Chung
a Department of Ophthalmology , Yeouido St. Mary's Hospital, The Catholic University of Korea , Seoul , Korea.
Hyun Seung
HS
Kim
a Department of Ophthalmology , Yeouido St. Mary's Hospital, The Catholic University of Korea , Seoul , Korea.
Kyung-Sun
KS
Na
D003228:Conjunctiva / Q000637:transplantation*; D057112:Corneal Perforation / Q000209:etiology / Q000517:prevention & control*; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000150:complications* / Q000628:therapy; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D013524:Surgical Flaps; D013997:Time Factors
D005938:Glucocorticoids
Barrier; conjunctiva; corneal perforation; graft-versus-host disease; pedicle flap