ISSN 2398-2993      

Bulbar conjunctival pedicle flap

obovis
Contributor(s):

Lucy Jerram

Kristina Mueller

RVC logoMassey School of Veterinary Science logo

Synonym(s): ophthalmic surgery


Introduction

  • This technique is not commonly used in cattle, but given the effectiveness of this technique in companion animals, perhaps it should be considered more often!
  • This technique is used to physically support a weakened cornea and provide blood supply directly to a corneal ulcer or injury.
  • The conjunctival flap will adhere to any areas where corneal epithelium is missing providing increased blood supply, nutrition and immune response.

Uses

Advantages

  • Provides direct supply of blood and therefore vascular based growth factors, fibroblasts and anti-proteases to the cornea.
  • Provides physical support to the thin cornea.
  • Allows continued visualization of the cornea and intraocular structures.

Disadvantages

  • Conjunctival flap techniques all require dissection of conjunctiva from Tenon's capsule (episcleral fascia); if this is not performed, then flap elasticity may be reduced, which can increase the tendency of graft or flap failure.
  • Will cause a degree of long term corneal opacity at the ulcer site.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • If technically correct, the majority of even deep ulcers will heal with conjunctival flaps.
  • Scars will form at the ulcer site.

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Plummer C, Smith S, Andrew S, Lassaline M, Gelatt K, Brooks D, Kallberg M & Ollivier F (2007) Combined keratectomy, strontium-90 irradiation and permanent bulbar conjunctival grafts for corneolimbal squamous cell carcinomas in horses (1990–2002): 38 horses. Vet Ophthal 10, 37-42 PubMed.
  • Ollivier F J (2005) Medical and surgical management of melting corneal ulcers exhibiting hyperproteinase activity in the horse. Clin Tech Eq Pract 4, 50-71 Sciencedirect.
  • Holmberg D L (1981) Conjunctival pedicle grafts used to repair corneal perforations in the horse. Can Vet J 22, 86-89 PubMed.

Other sources of information

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