What surgical procedure is recommended for more than 50% stromal loss in a deep stromal ulcer?

When a deep stromal ulcer has resulted in more than 50% loss of the corneal stroma, a conjunctival pedicle flap is recommended as the surgical procedure of choice. This technique involves using a piece of conjunctiva—part of the tissue covering the eye and eyelids—to create a flap that covers the damaged area of the cornea.

The rationale behind employing a conjunctival pedicle flap in this situation stems from its ability to provide vascularized tissue that supplies nutrients and promotes healing of the corneal stroma. It also serves as a protective barrier against further damage or infection while simultaneously allowing for the management of the underlying pathology of the ulcer. This is crucial, especially when dealing with significant stromal loss, as the cornea's structural integrity is compromised.

In contrast, while other options like bandage contact lens placement may be suitable for superficial corneal issues or less severe cases, they would not adequately support a cornea that has lost over 50% of its stroma. Corneal scraping is primarily utilized for superficial corneal lesions and does not address deep stromal defects effectively. Laser therapy can be beneficial for certain corneal conditions but does not provide the same level of support and healing that a conjunctival pedicle flap