[2 years experiences with Tenon-plasty].

Tenon plasty proved useful in eye burns, especially in cases involving corneoscleral ulceration. This surgical procedure was carried out in 24 severely burned eyes of 21 patients. A total of 75 Tenon flaps were prepared, each of them covering one quadrant of the anterior eye segment. In 13 cases the burns were fresh, showing necrotic and ischemic areas in the sclera. In seven eyes an extended corneoscleral ulceration had developed and was covered with Tenon plasty. In four cases, when highly inflamed tissue was removed from the limbus the proximal conjunctiva retracted and exposed large areas of the sclera. Again, Tenon plasty was carried out. In all cases, the damage was so extensive that no conjunctiva was available to form flaps for plastic repair. Besides, the extensive ischemia would not allow free transplants. The duration of postoperative observation after Tenon plasty ranged from 6 to 42 months. In 14 of 24 eyes the denuded corneal stroma was covered with an artificial epithelium. In 11 cases keratoplasty was performed. The conjunctival epithelium regenerated in 10 eyes within 10 days, in another 10 eyes within 20 days, and in 4 eyes within 50 days. In all cases, the corneoscleral ulceration healed. Although some symblephara formed, and in a number of cases the cornea became more turbid and vascularized, Tenon plasty was very helpful in shortening the period of intensive inpatient treatment and provided a sound foundation for further reconstructive surgery.