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.