Numerous techniques have been advocated for reconstruction of cul-de-sacs when a globe is present. A general discussion of the subject will not be attempted in this paper, the main purpose of which is to show a simple technique, using a modified Sato graft, along with other and older techniques for cul-de-sac reconstruction.
Symblepharon is excised from the cornea and the deep tissues are undermined sufficiently to reform the cul-de-sac. The flap of tissue from the cornea and sclera is thinned out and used to reline the inner lid surface. A peritomy is continued 1 mm from the limbus 360° around the globe. A 5 mm bridge flap is taken 180° from the defect (Figure, B) and sutured into position at the limbus with multiple interrupted sutures of 6-0 chromic (Figure, C). The donor area is closed with a continuous suture of 6-0 silk. The defect on the sclera is covered
TENZEL RR. Cul-de-Sac Reconstruction. Arch Ophthalmol. 1966;76(4):580. doi:10.1001/archopht.1966.03850010582018