Finger Paul T
From the Department of Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy, The New York Eye Cancer Center, New York, NY, 10065, USA.
Tulane University School of Medicine, New Orleans, LA, 70118, USA.
Am J Ophthalmol Case Rep. 2025 Jul 22;39:102394. doi: 10.1016/j.ajoc.2025.102394. eCollection 2025 Sep.
To describe a bipedicle conjunctival flap technique that offered symmetrical, thus structurally stabile, double-vascularized ocular surface reconstruction.
A unilateral, inferior, severe corneal neovascularization with subepithelial fibrosis and partial limbal stem cell deficiency evolved over 1 year, covering 270 degrees of the cornea. There was no history of ocular trauma, chemical injury, pharmacologic drops, prior incisional conjunctival or retinal surgery. Ophthalmic oncology and uveitis evaluations were negative. Due to progressive covering of the visual axis, an excisional biopsy followed by a novel "bucket-handle" bipedicle conjunctival flap was performed. Superior bulbar conjunctiva was mobilized and advanced to cover the entire defect and sewn to the margin of conjunctival resection. Then, a central conjunctival corneal window was resected to expose the cornea and allow for vision. However, it also allowed for one continuous, vascularized conjunctival nasal to temporal pedicle flap.
A "bucket-handle" conjunctival flap provided a continuous bipedicle, arcuate tissue replacement, and a structurally stable barrier to conjunctival regrowth.
描述一种双蒂结膜瓣技术，该技术可提供对称的、因此结构稳定的、双血管化的眼表重建。
单侧下方严重角膜新生血管化伴上皮下纤维化和部分角膜缘干细胞缺乏，病程1年，累及角膜270度。无眼外伤、化学伤、药物滴眼史，既往无结膜切开或视网膜手术史。眼科肿瘤学和葡萄膜炎评估均为阴性。由于视轴逐渐被遮盖，进行了切除活检，随后采用了一种新型的“桶柄状”双蒂结膜瓣。上方球结膜被游离并推进以覆盖整个缺损，然后缝合至结膜切除边缘。接着，切除中央结膜角膜窗以暴露角膜并恢复视力。然而，这也形成了一个连续的、血管化的从鼻侧到颞侧的结膜蒂瓣。
“桶柄状”结膜瓣提供了连续的双蒂、弧形组织替代物，以及对结膜再生的结构稳定屏障。
