Tarsoconjunctival pedicle flap for the management of a severe scleral melt

Cornea. 2007 Feb;26(2):235-7. doi: 10.1097/01.ico.0000248386.55014.51.


Purpose: To describe the use of a tarsoconjunctival pedicle flap for the repair of a large scleral melt in a patient with rheumatoid arthritis.

Methods: Case report and literature review.

Results: A 36-year-old woman with a history of rheumatoid arthritis presented to the Rocky Mountain Lions Eye Institute with a large scleral melt in the right eye. Ophthalmic examination revealed a visual acuity of 20/400 and a superior scleral melt measuring 15 x 30 mm. After instituting systemic immunosuppression, a tarsoconjunctival pedicle was used to provide tectonic support to the globe. At her 3-month postoperative visit, her vision improved to 20/30, and the scleral melt was completely epithelialized.

Conclusions: A tarsoconjunctival pedicle flap provides an excellent alternative to help restore scleral integrity in patients with severe autoimmune necrotizing scleritis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arthritis, Rheumatoid / complications
  • Conjunctiva / transplantation*
  • Female
  • Follow-Up Studies
  • Humans
  • Scleritis / etiology
  • Scleritis / pathology
  • Scleritis / surgery*
  • Severity of Illness Index
  • Surgical Flaps*
  • Suture Techniques