Alino A M, Perry H D, Kanellopoulos A J, Donnenfeld E D, Rahn E K
Department of Ophthalmology, Nassau County Medical Center, East Meadow, New York, USA.
Ophthalmology. 1998 Jun;105(6):1120-3. doi: 10.1016/S0161-6420(98)96017-1.
The authors reviewed their experience with total conjunctival flaps (TCF) and partial conjunctival flaps (PCF) for the past 5 years in 61 patients.
Forty-eight patients had TCF and 13 had PCF. Diagnoses for surgery included severe bullous keratopathy for chronic graft failure (not candidates for keratoplasty) (19), herpes zoster ophthalmicus (7), chronic ulcerative keratitis (14), neurotrophic keratitis (2), and herpes simplex keratitis (9).
There were seven complications. Four flap retractions occurred in the TCF group, requiring resuturing in two. Three complications occurred in the PCF group. One patient had two flap retractions and recurrent ulceration, requiring tarsorrhaphy. One patient with PCF suffered a perforation after flap retraction, necessitating penetrating keratoplasty.
The authors believe conjunctival flaps are underused and should be considered seriously for bullous keratopathy, neurotrophic keratitis, recalcitrant keratitis, and persistent nonhealing epithelial defects.
作者回顾了过去5年里61例患者行全结膜瓣（TCF）和部分结膜瓣（PCF）手术的经验。
48例患者行TCF手术，13例患者行PCF手术。手术诊断包括慢性移植失败导致的严重大疱性角膜病变（不适合角膜移植）（19例）、带状疱疹性眼炎（7例）、慢性溃疡性角膜炎（14例）、神经营养性角膜炎（2例）和单纯疱疹性角膜炎（9例）。
共出现7例并发症。TCF组发生4例瓣回缩，其中2例需要再次缝合。PCF组发生3例并发症。1例患者出现2次瓣回缩和复发性溃疡，需要行睑裂缝合术。1例PCF患者在瓣回缩后发生穿孔，需要行穿透性角膜移植术。
作者认为结膜瓣的应用未得到充分重视，对于大疱性角膜病变、神经营养性角膜炎、顽固性角膜炎和持续性不愈合的上皮缺损，应认真考虑使用结膜瓣。
