Modified Gunderson Conjunctival Flap Combined with an Oral Mucosal Graft to Treat an Intractable Corneal Lysis after Chemical Burn: A Case Report

Abstract

Following a severe chemical injury, persistent corneal melting presents as a threatening condition for loss of vision or the eyeball itself. Keratoplasty (both lamellar and penetrating) and amniotic membrane transplantation have been the usual modes of therapy. However, these may not halt the persistent melting process. We introduce here an alternative surgical procedure to resolve corneal melting and preserve the globe. This case concerns the right eye of a 36-year-old male who had suffered from severe ocular alkali chemical burns and sustained intractable corneal melting, despite receiving corneal transplants three times, a limbal stem cell transplantation once, a scleral graft twice, and amniotic membrane transplantation eight times. To circumvent the impending perforation, we performed a modified Gunderson conjunctival flap combined with an oral mucosal graft. The corneal melting was halted, and the eyeball was preserved. The combination of an oral mucosal graft to the modified Gunderson conjunctival flap provided an easy alternative to resolve a case of intractable corneal melting and impending perforation.

Keywords

• conjunctival flap
• corneal lysis
• chemical burn