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Suffering with occular HSV-1, split cornea, no relief with anti-viral or inflammatory medicines. Information about Gundersen Flap?

id like to know about Gundersen Flap, Im waiting on this surgery because I have occular HSV-1 , a split cornea and my eye has been resistant to all treatment and anti viral/inflammatory medication now for 3 yrs. A corneal transplant is supposedly an instant failure because of the virus, Im scared and not sure what i should do or why my eye is such a pain. I really need an ophthalmologist who is a super smarty who can help me with my painful eye.
Asked On : Fri, 25 Jan 2013
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Ophthalmologist 's  Response
Hi,I read your case of ocular HSV1 with split cornea and severe pain post 3 years of treatment.Gundersen flap is a conjunctival flap indicated in many conditions like refractory infectious ulceration(i.e Your case due to HSV1 infection), ocular surface disorders, exposure keratopathy, bullous keratopathy etc where the patient has less visual potential and drug treatment is refractory and the patient is suffering from severe pain.Since you fulfill all the three criteria its better to go for Gundersen flap surgery where your whole of cornea will be covered by your own conjunctiva.It is not a major surgery and complications are very few like flap retraction, button hole , cyst .But if you have visual potential then corneal transplant can be done with good post operative management.There are chances of graft failure but it better to give a try.I would advise, if no visual potential go for Gundersen flap and you will get an instant relief from pain but cosmetically it doesn't look good.If there is a visual potential go for penetrating keratoplasty....So don't worry for now. Go to a good corneal surgeon in your town and discuss your case.. TC..DR Ajay Shankar Kar,Cornea consultant, Sankar foundation eye hospital, Visakhapatnam.
Answered: Tue, 29 Jan 2013
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