A Case of Conjunctival Autotransplantation Using Conjunctival Flap of Pterygium in Treating Corneal Ulcer Perforation

Abstract

Purpose: To report a case of conjunctival autotransplantation using the conjunctival flap of the pterygium for thetreatment corneal ulcer perforation. Case summary: A 72-year-old woman was referred to our hospital because her left eye had a corneal ulcer due topine needle trauma, and she did not respond to the initial therapy in a private clinic for 1 week. We first applied topical and systemic antibiotics. However, the lesion did not subside, and necrosis progressed in the stroma at the center of the cornea. On day 6 of admission, perforation was found at the center of the cornea, and we excised the necrotic tissue and performed bilateral pedicle conjunctival flap transposition. After the operation, an ischemic change was observed, and in the fourth week perforation occured at the center of the transplanted conjunctival flap. Because we considered it difficult to perform the transplantation of a conjunctival flap in the left eye, we performed autotransplantation on the corneal perforation in the left eye using conjunctival flap obtained through a pterygium excision in the right eye. After the operation, vascular ingrowth started from the edge of the flap, and there were no symptoms of inflammation, shrinkage, or necrosis of the flap. During the follow-up observation, the flap survived well without necrosis.