ROLE OF CONJUNCTIVAL FLAP OPERATION IN FUNGAL KERATITIS

Abstract

T he management of recalcitrant fungal keratitis often poses great therapeutic difficulties. In this regard, a study
was conducted to emphasize upon the importance of conjunctival flap operation in cases of fungal keratitis not
responding to topical and systemic anti-fungal agents and to assess improvement in these patients. Twenty-five
patients with fungal keratitis were selected and conjunctival flap operation was performed between July 1999-August
2000. Nineteen were male and six were female patients. Patients' age was between 8-60 years. Excellent results were
obtained by this method in selected cases of fungal keratitis. Pain in the eye subsided in all patients. Marked
improvement also occurred in corneal inflammation, hypopyon and associated uveitis. Triggering factors were trauma
(60%), topical steroids (20%), use of antibiotics (46%), diabetes and chronic ill health (24%), males were 76% and
females were 24%. The type of procedure included advancement flap (32%), single pedicle (32%), bipedicle (16%)
and total flap (20%). Complications included upward retraction of flap in 2 cases and buttonhole formation in 2 cases.
The purpose of this study is to highlight the importance of conjunctival flap operation in cases of selected fungal
corneal ulcers. More work is suggested to improve upon the efficacy and results of this procedure.