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This is Matt Rauen showing an
example pterygium surgery with amniotic membrane grafting.
We begin the procedure by marking
the area of planned conjunctival excision.
we do this with a marking pen. In many cases will also utilize
the fixation suture in order to move the globe
where we need it to be.
We use vicryl suture in this case.
We use Wescott scissors to
initiate the dissection posteriorly we simply carry that
more anteriorly see a separating
denounced issue a couple other areas once we get to the
limbal region we utilize additional dissection both blunt
and with the blade
and oftentimes with repealing motion in this particular case there was a lot of
vascularization.
you'll notice the cornea white mean those still present this is very
deep in the Korean take care to not try to address all this with this primary
procedure
what we try to do is remove any vascularized tissue
both within the tritium had also at the limbus
would you like to recess denounced issue
and in this case as we felt it was a high-risk
case we do use mitomycin c
and keep away from the limbus. We use 10 to 15 CC's a balanced salt solution
to rinse the area. We now bring in the amniotic membrane
and this is the factor in this procedure that I think can lead to very quick
rehabilitation
excellent cosmetic result we cut this to appropriate size
and smooth it onto the corneal surface
and then using the individual components of tisseel glue
reply to the amniotic membrane and then next to
sclera we then flipped the American membrane into place
and using a blunt ended instrument
and in this case the smooth muscle hook we are in that flat
onto the scleral surface
one will have approximately attend the fifteen seconds to manipulate the graft
and virtually every case a little bit of glue goes a long way
we then use the same
tisseel to cover up the posterior extent
up the graft with the conduct tiver at the conclusion the case
you have a nice anatomical result
the patient will experience very quick rehabilitation
thank you for your attention