Objective      To evaluate the clinical curative effect of conjunctival flap covering surgery on treatment of refractory corneal diseases.       Methods      A retrospective study reviewed case records of 161 patients with refractory corneal diseases

who underwent conjunctival flap covering surgery in our center from 2001 to 2014. There were 118 cases with infective corneal ulcer (71 cases with fungal corneal ulcer

16 cases with bacterial corneal ulcer

and 31 cases with herpes simplex virus corneal ulcer) and 43 cases with non-infective corneal diseases (22 cases with bullous keratopathy

6 cases with neurotrophic keratitis

10 cases with corneal keatoplasty ulcer

and 5 cases with extraction of foreign bodies in the deep layer of cornea). The medical treatment for the primary disease continued in the postoperative period. The follow-up ranged from 3 months to 106 months to observe the curative effects.       Results      Among 161 cases

141 cases were healed and the curative rate was 87.6%. Ninety-nine of 118 cases with infective corneal ulcer and 42 of 43 cases with non-infective corneal diseases were healed

and the curative rates were 83.9% and 97.7%

respectively. Among them

the curative rates of fungal keratitis (54/71)

bacterial keratitis (15/16) and herpes simplex virus keratitis (30/31) were 76.1%

93.8%

and 96.8%

respectively. There was significant difference in the success rate between the infective corneal ulcer and non-infective corneal diseases (P=0.048)

and the curative rate of non-infective corneal diseases was outstanding. In infective corneal diseases

the efficacy of herpes simplex virus corneal ulcer was better than that of fungal corneal ulcer and bacterial corneal ulcer (P=0.047). There were 21 cases of complications

including partial dissolution (11 cases)

perforation (4 cases)

retraction of the flaps (4 cases) and secondary glaucoma (2 cases). There were 20 cases of postoperative complications in infective corneal diseases (incidence rate 16.9%) and 1 case in non-infective corneal diseases (incidence rate 2.3%). The difference was statistically significant in the complication incidence (P=0.015)

and the complication incidence of non-infective corneal diseases was far lower than that of infective corneal diseases.       Conclusions      Conjunctival flap covering surgery is an effective way in treatment of refractory corneal diseases. The curative effect of non-infective keratitis is better than that of infective corneal diseases. For acute pyogenic corneal ulcer

the preoperative medical treatment is helpful to improve the success rate of surgery.