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  • Title: Tarsoconjunctival pedicle flap for the management of a severe scleral melt.
    Author: Davidson RS, Erlanger M, Taravella M, Gregory DG, Durairaj VD.
    Journal: Cornea; 2007 Feb; 26(2):235-7. PubMed ID: 17251823.
    Abstract:
    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.
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