Excision of circumscribed conjunctival melanoma with amniotic membrane transplantation

Conjunctival melanoma can arise from a nevus, de novo, or from primary acquired melanosis. Increasing recurrence after superficial removal of circumscribed conjunctival melanoma led to the development of wide excision with adjuvant cryotherapy as the mainstay of treatment. Additional measures including alcohol epitheliectomy, cryotherapy, and chemotherapy have been used in an effort to decrease the risk of recurrence and metastasis. The combination of wide excision of the tumor with 4- to 6-mm margins, alcohol epitheliectomy of the involved cornea, superficial sclerectomy of adherent melanoma, application of cryotherapy to adjacent areas, and sutureless closure with amniotic membrane (AM) is our preferred treatment. The purpose of this article was to describe the technique for removal of circumscribed conjunctival melanoma at the limbus with sutureless AM surface reconstruction.