The Ophthalmic Office Procedures Handbook

SECTION 5 Cornea and Conjunctiva

460

FIGURE 25-2 Corneal debridement procedure shown. A, Loose epithelium is removed with a surgical spear. B, Depression of cornea shown. C, Golf spud is used to further remove tissue and smoothen out layers. D, Diamond burr polishing of Bowman’s layer to remove persistent epithelial attachments is shown.

7. Recommended: diamond burr polishing a. Perform diamond burr polishing by making gentle uniform circular movements no more than 30 seconds at a time to avoid too much pressure. Rotations of the diamond burr head should be directed toward the visual axis to avoid limbal cell damage. 8. Instill topical ophthalmic antibiotic after the procedure. 9. Insert BCL in the treated eye for pain management and wound coverage. a. Consider AM placement for improved surface healing. 10. Remove the lid speculum being careful not to dislodge or disturb the BCL or AM device. FOCAL DEBRIDEMENT (WHEN TREATING A PORTION OR SECTION OF THE CORNEA) 1. Clean the eyelid and lashes of the affected eye with standard povidone–iodine 10% swab stick (Betadine). 2. Instill topical ophthalmic proparacaine and apply a sterile drape as necessary. 3. Insert eyelid speculum in the affected eye as necessary. 4. Test for area of loose tissue with a dry surgical spear sponge or sterile cotton swab.

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