Five Years’ Experience with Tenon-Conjunctival Flaps in Phthisical Eyes

Alicia Galindo-Ferreiro, Patricia Santello Akaishi, Mohammad Al-Aliwi, Eric Niespodzany, Alberto Gálvez-Ruiz, Antonio Augusto Velasco Cruz

Research output: Contribution to journalArticle

Abstract

Background: To evaluate the efficacy of total Tenon-conjunctival flaps (TCFs) for coverage of phthisical eyes with normal corneal sensitivity. Methods: A retrospective chart review was performed on 142 patients with mild monocular phthisis who underwent the TCF procedure to allow monocular scleral shell fitting at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. All patients had normal corneal sensation in their painless phthisical eye and were intolerant to cosmetic scleral shell fitting preoperatively. Consecutive patients over a five-year period were enrolled. Data were collected on functional success, duration of follow-up, and complications. The Tenon’s and conjunctival layers were closed separately in 103 eyes and as a single layer in the remaining 39 eyes. Main outcome measures were functional success, defined as tolerance to the prosthetic scleral shell, and rate of postoperative complications such as wound retraction, epithelial cysts, and blepharoptosis. Fisher’s exact test was used to analyze the association between the main outcome measures and type of flap closure. Results: The mean duration of follow-up was 23.7±17.43 months. Functional success was achieved in 98.6% of eyes. Minor complications included epithelial inclusion cysts in 10 (7.04%) eyes and mild blepharoptosis in 9 (6.34%) eyes. Overall flap retraction was noted in 14 (9.86%) eyes. This complication occurred in 13 of 103 (33.3%) eyes with double layer closure and in 1 of 39 (0.97%) eyes with a single layer flap closure (p=0.11). Conclusions: TCF is an effective procedure to increase corneal thickness for coverage in phthisical eyes with positive corneal sensation. The incorporation of Tenon’s capsule in the flap did not increase complications with a frequency similar to the classic Gundersen procedure.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalSeminars in Ophthalmology
DOIs
StateAccepted/In press - Jul 3 2016
Externally publishedYes

Fingerprint

Blepharoptosis
Cysts
Tenon Capsule
Outcome Assessment (Health Care)
Saudi Arabia
Cosmetics
Wounds and Injuries

Keywords

  • Blindness
  • corneal
  • cosmesis
  • sensation
  • shell
  • tolerance

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Galindo-Ferreiro, A., Akaishi, P. S., Al-Aliwi, M., Niespodzany, E., Gálvez-Ruiz, A., & Cruz, A. A. V. (Accepted/In press). Five Years’ Experience with Tenon-Conjunctival Flaps in Phthisical Eyes. Seminars in Ophthalmology, 1-5. https://doi.org/10.3109/08820538.2016.1143517

Five Years’ Experience with Tenon-Conjunctival Flaps in Phthisical Eyes. / Galindo-Ferreiro, Alicia; Akaishi, Patricia Santello; Al-Aliwi, Mohammad; Niespodzany, Eric; Gálvez-Ruiz, Alberto; Cruz, Antonio Augusto Velasco.

In: Seminars in Ophthalmology, 03.07.2016, p. 1-5.

Research output: Contribution to journalArticle

Galindo-Ferreiro, A, Akaishi, PS, Al-Aliwi, M, Niespodzany, E, Gálvez-Ruiz, A & Cruz, AAV 2016, 'Five Years’ Experience with Tenon-Conjunctival Flaps in Phthisical Eyes', Seminars in Ophthalmology, pp. 1-5. https://doi.org/10.3109/08820538.2016.1143517
Galindo-Ferreiro A, Akaishi PS, Al-Aliwi M, Niespodzany E, Gálvez-Ruiz A, Cruz AAV. Five Years’ Experience with Tenon-Conjunctival Flaps in Phthisical Eyes. Seminars in Ophthalmology. 2016 Jul 3;1-5. https://doi.org/10.3109/08820538.2016.1143517
Galindo-Ferreiro, Alicia ; Akaishi, Patricia Santello ; Al-Aliwi, Mohammad ; Niespodzany, Eric ; Gálvez-Ruiz, Alberto ; Cruz, Antonio Augusto Velasco. / Five Years’ Experience with Tenon-Conjunctival Flaps in Phthisical Eyes. In: Seminars in Ophthalmology. 2016 ; pp. 1-5.
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abstract = "Background: To evaluate the efficacy of total Tenon-conjunctival flaps (TCFs) for coverage of phthisical eyes with normal corneal sensitivity. Methods: A retrospective chart review was performed on 142 patients with mild monocular phthisis who underwent the TCF procedure to allow monocular scleral shell fitting at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. All patients had normal corneal sensation in their painless phthisical eye and were intolerant to cosmetic scleral shell fitting preoperatively. Consecutive patients over a five-year period were enrolled. Data were collected on functional success, duration of follow-up, and complications. The Tenon’s and conjunctival layers were closed separately in 103 eyes and as a single layer in the remaining 39 eyes. Main outcome measures were functional success, defined as tolerance to the prosthetic scleral shell, and rate of postoperative complications such as wound retraction, epithelial cysts, and blepharoptosis. Fisher’s exact test was used to analyze the association between the main outcome measures and type of flap closure. Results: The mean duration of follow-up was 23.7±17.43 months. Functional success was achieved in 98.6{\%} of eyes. Minor complications included epithelial inclusion cysts in 10 (7.04{\%}) eyes and mild blepharoptosis in 9 (6.34{\%}) eyes. Overall flap retraction was noted in 14 (9.86{\%}) eyes. This complication occurred in 13 of 103 (33.3{\%}) eyes with double layer closure and in 1 of 39 (0.97{\%}) eyes with a single layer flap closure (p=0.11). Conclusions: TCF is an effective procedure to increase corneal thickness for coverage in phthisical eyes with positive corneal sensation. The incorporation of Tenon’s capsule in the flap did not increase complications with a frequency similar to the classic Gundersen procedure.",
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