Felis ISSN 2398-2950

Conjunctival graft

Synonym(s): Conjunctival Flap

Contributor(s): Miss Heidi J Featherstone, Rhea Morgan

Introduction

  • Surgical technique that utilizes bulbar conjunctiva to close or provide structural support to deep stromal defects of the cornea.
  • Conjunctiva is freed from the episcleral fascia and transposed over the corneal defect.
  • The graft is usually left attached at the base so that a viable blood supply is brought to the cornea.

Uses

  • Deep stromal ulcers and descemetoceles.
  • Corneal perforations and wounds.
  • Following lamellar keratoplasty for the removal of deep corneal sequestra, stromal neoplasms, or other lesions.
  • Bullous keratopathy.

Advantages

  • Provides immediate support to a very thin or weak cornea.
  • Introduces a good vascular supply to the lesion.
  • The graft is autogenous, so rejection is not a problem.

Disadvantages

  • Creates an opaque area on the cornea, so may decrease vision if it overlies the pupil.
  • Usually requires a second surgery at a later date to trim the graft.
    Second surgery to trim graft often possible while cat conscious with topical anesthesia or under sedation. GA not usually necessary.

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

  • Good once the first post-operative week has passed uneventfully.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Glover T L, Nasisse M P, Davidson M G (1994) Acute bullous keratopathy in the cat. Vet Comp Ophthalmol (2), 66-70 VetMedResource.
  • Glaze M B (1989) Corneal ulceration: medical and surgical management. Proc Kal Kan Symposium 13, 103-108.
  • Hakanson N, Lorimer D & Merideth R E (1988) Further comments on conjunctival pedicle grafting in the treatment of corneal ulcers in the dog and cat. J Am Anim Hosp Assoc 24 (6), 602-605 VetMedResource.
  • Hakanson N E & Merideth R E (1987) Conjunctival pedicle grafting in the treatment of corneal ulcers in the dog and cat. J Am Anim Hosp Assoc 23 (6), 641-648 VetMedResource.

Other sources of information

  • Slatter D (2001) Fundamentals of Veterinary Ophthalmology. 3rd Ed. WB Saunders, Philadelphia, pp. 303-308.
  • Petersen-Jones S & Crispin S (2002) BSAVA Manual of Small Animal Ophthalmology. 2nd edn. British Small Animal Veterinary Association. ISBN 0 905214 54 4


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