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J. G. McHenry, R. Ghaiy; Tarso-Conjunctival Bridge Grafts from Both Upper and Lower Lids for Severe Tissue Loss and Proptosis Leading to Intractable Exposure Keratopathy and Corneal Ulceration. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1485.
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When eyelid tissue is not available to cover the cornea, the epithelium is subject to severe exposure keratopathy and ulceration. We describe two cases of severe intractable exposure secondary to massive proptosis and periorbital ischemia with tissue loss treated with tarso-conjunctival bridge grafts from both the upper and lower lids.
The records of two patients with severe eyelid exposure treated with tarso-conjunctival bridge graft were reviewed.
Both patients' corneal epithelium healed, allowing time for later reconstruction of the eyelids and visual rehabilitation.
Tarso-conjunctival bridge grafts from both the upper and lower lids are sewn together over the corneas. They provide excellent corneal protection in the face of intractable exposure, allowing for reepithelialization of the cornea in the critically ill patient with severe exposure keratopathy.
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