Surgical Procedure for Treating Partial LSCD with Amniotic Membrane Transplantation (AMT)

Partial LSCD presented as psuedopterygium and treated with excision and AMT
         Before treatment                     After treatment

Surgial Steps:

1. Remove the corneal pannus via blunt superficial keratectomy
   
2. Polish the corneal surface with a dental burr (only if uneven).
    
3. Perform amniotic membrane transplantation using fibrin glue to cover the affected corneal surface and the bare sclera (as a Permanent graft).
    
4. Spare the visual axis if the remaining corneal stroma is smooth and clear centrally by opening a 6 mm diameter window on AM.
    
5. If fibrin glue is not used, the cryopreserved amniotic membrane can be secured by several interrupted 10-0 nylon sutures on peri-limbal bulbar conjunctiva and by 8-0 Vicryl sutures in a mattress fashion, parallel to the fornix, with solid episcleral bites to seal the fornix border.
    
6. InsertPROKERA© to cover the cornea and the limbal area (as Temporary biologic graft).  The benefits of cryopreserved amniotic membrane will be delivered through this sutureless conformer ring, which protects the cornea from external trauma while exerting biologic supportive functions to all covered parts of the ocular surface.

Click here to view a video showing the procedure for AMT for Partial LSCD.

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