PMC10220433_01
Postchemical injury day 1: conjunctival chemosis, extensive bulbar, and palpebral conjunctival staining, diffuse sloughing of the conjunctival epithelium, and four clock hours of perilimbal whitening inferiorly
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F1
The exam showed 3+ conjunctival chemosis, extensive staining of the bulbar and palpebral conjunctiva, diffuse sloughing of the conjunctival epithelium, and four clock hours of perilimbal whitening OS [Figure 1].
Postoperative day 1: intact AMT draped over the eyelid margins with the symblepharon ring in place. Note the running nylon suture near the inferior eyelid margin. Although not well shown, four 9-0 Vicryl sutures also secured the AM to the episclera about 2 mm from the limbus at the 3, 6, 9, and 12 o'clock positions. AMT: Amniotic membrane transplantation
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F2
On the 1st postoperative day, the AM was intact and the KED was grossly unchanged [Figure 2].
Postoperative week 3: dissolved AMT, persistent corneal epithelial defect, and resolved conjunctival staining. The externally sutured AMT and symblepharon ring were removed with subsequent placement of ProKera Plus (TissueTech, Doral, Florida). AMT: Amniotic membrane transplantation
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F3
The eyelid sutures and symblepharon ring were removed and a ProKera Plus (TissueTech, Doral, Florida) was placed [Figure 3].
Postoperative week 8: the corneal epithelial defect has completely resolved and the conjunctiva is quiet with minimal scarring. There is a mild resolving corneal haze
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F4
By postoperative month 2 and 4, the KED had resolved with mild residual central anterior stromal haze, there was minimal conjunctival scarring, and the patient's best-corrected visual acuity was 20/25 [Figure 4].