Sequential Sector Conjunctival Epitheliectomy (SSCE) for Enhancement of Corneal Epithelial Regeneration
Dua H. S.
Division of Ophthalmology and Visual Sciences, University of Nottingham, England
Purpose: To describe a method for the prevention of conjunctivalisation of the cornea following superficial epithelial damage and for facilitating corneal epithelial regeneration in the management of partial limbal stem cell deficiency.
Method: Following acute ocular surface injury, when part of the corneo scleral limbus survives, corneal epithelial regeneration occurs from the remaining intact limbal epithelium which migrates in a circumferential manner. However on occasions, conjunctival epithelium migrates across the limbs and covers the cornea. Gentle brushing off of the advancing conjunctival epithelium (in acute cases) or removal of the conjunctival epithelium from the corneal surface (in established cases) under topical anaesthesia, using a surgical blade is carried out. This may be repeated to ensure that corneal surface cover is afforded by corneal/limbal derived epithelial cells.
Results: This method has been termed as (Dua's) Sequential Sector Conjunctival Epitheliectomy and has been used successfully in the management of acute and established cases of partial limbal deficiency, in the absence of a fibrovascular pannus. It is also a useful adjunct in preventing conjunctival epithelium from advancing on to the cornea in patients who under auto or allo limbal transplantation. It ensures corneal epithelial cover for the cornea improving vision and reducing symptoms
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