Conjunctiva has to be replaced when a large enough area is destroyed so as to cause a high degree of symblepharon or entropion or when the socket is too small to carry a prosthesis. Most common causes of its destruction are chemical and thermic burns and trachoma. Rare causes are malignant tumor, pemphigus, tuberculous ulcer, mechanical injury and amyloid and hyaline degeneration.
Conjunctiva can be replaced primarily immediately after its loss. This has to be done after the removal of the necrotic conjunctiva. Denig1 introduced the method by which necrotic conjunctiva is removed immediately after the chemical burn and the defect is covered with mucous membrane. However, the conjunctiva usually has to be replaced when symblepharon has already developed.
Veasey1a revised the materials which are or have been used to cover the defects of the conjunctiva. These consist of grafts of conjunctiva, of the inner surface of the
de RÖTTH A. PLASTIC REPAIR OF CONJUNCTIVAL DEFECTS WITH FETAL MEMBRANES. Arch Ophthalmol. 1940;23(3):522–525. doi:10.1001/archopht.1940.00860130586006