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Corneo Conjunctival Transposition (CCT) grafts
Conjunctival pedicle grafts are used to treat deep corneal ulcers.
CCT grafting is performed with the patient under general anaesthetic, and with the aid of an operating microscope. Using microsurgical instruments, a half-thickness area of cornea is dissected from one edge of the ulcer and extended to the edge of the cornea. Further dissection is then performed to free an area of conjunctiva. This results in a flap of cornea connected to conjunctiva which remains attached to the margin of the eye. This flap is then slid across to cover the ulcer and is stitched in place using very fine suture material (see diagram). Depending on the case, additional procedures such as a third eyelid flap or temporarily stitching the eyelids partially closed may be performed to help protect the graft and eye.
What happens after the operation?
We will usually recommend a check-up examination around 3-4 weeks following the surgery to ensure that the eye is healing satisfactorily. In some cases a brief general anaesthetic is required at this stage to remove the stitches, although this is not always necessary.
Does the graft need removing, and what is the effect on vision?
This type of graft is not removed and the area where the original ulcer was should ultimately be relatively transparent with reasonable vision, although there will be some pigmentation and scarring of the cornea more peripheral to this. To reduce scarring, we often dispense a course of eye ointment (‘Optimmune’) for a month or two following the surgery.