Pillar tarsoconjunctival flap: An alternative approach for the management of refractory corneal ulcer

Eur J Ophthalmol. 2022 Nov;32(6):3383-3391. doi: 10.1177/11206721221085400. Epub 2022 Mar 10.

Abstract

Purpose: To report the effectiveness of the surgical procedure of the tarsoconjunctival flap (FTC) in patients with severe ocular surface impairment refractory to previous conventional treatments.

Methods: A retrospective, noncomparative, consecutive case series.

Results: Pillar tarsoconjunctival flap (PTCF) was performed in eight eyes of eight patients. Three patients had neurotrophic corneal ulcer (NCU), three had exposure keratopathy and two had corneal melting. Seven of them had satisfactory postoperative results, showing total corneal re-epithelialization that lasted throughout the postoperative follow-up (mean 10.33 ± 2.65 months [SD], range 6 to 12 months). Mean time for the re-epithelization was 11.28 ± 8.97 days [SD] (range 4 to 30 days).

Conclusion: This study suggest PTCF is a valid alternative to tarsorrhaphy in cases of persistent epithelial defect (PED) or NCU resistant to conventional treatments. Notwithstanding, prospective comparative trials comparing PTFC with conventional and/or novel therapies in PED or NCU are needed to corroborate these findings.

Keywords: Pillar tarsoconjunctival flap; blinking phenomenon; corneal melting; exposure keratopathy; neurotrophic keratopathy; ocular surface; tarsorrhaphy.

MeSH terms

  • Corneal Diseases* / surgery
  • Corneal Ulcer* / surgery
  • Eyelids / surgery
  • Humans
  • Keratitis*
  • Prospective Studies
  • Retrospective Studies
  • Surgical Flaps