The Ophthalmic Office Procedures Handbook

CHAPTER 25

459

Corneal Debridement

FIGURE 25-1 A majority of the equipment used in procedure videos shown here. BSS, buffer saline solution.

● Surgical spear sponges (Weck-cel) ● Sterile cotton swabs ● EtOH 20% ( optional ) ● Alcohol well ( optional ) ● Cotton corneal light shield ( optional ) ● Diamond burr ● Bandage contact lens (BCL) ● Amniotic membrane (AM) THE PROCEDURE 1,2,4,7,11,12

1. Clean the eyelid and lashes of the affected eye with standard povidone–iodine 10% swab stick (Betadine). 2. Instill topical ophthalmic anesthetic and apply a sterile drape. 3. Insert eyelid speculum in the affected eye. 4. Optional: alcohol delamination a. Apply 20% EtOH to the cornea using an alcohol well or a saturated cotton corneal light shield for 40 seconds. b. Absorb EtOH from alcohol well with surgical spear sponges or remove saturated light shield using forceps. 5. Using a dry surgical spear sponge, surgical blade, foreign body spud, or Amoils rotary brush, remove weakened epithelium (Figure 25-2). a. Leave at least 1 mm of peripheral epithelium at the limbus. Edges of the debrided area can be cleaned up using forceps. 6. Irrigate with BSS to remove epithelial debris.

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