The pigmented conjunctival lesion was outlined with blue ink, and subconjunctival lidocaine injected to elevated the lesion. Absolute alcohol was used to loosen the corneal epithelium, and the corneal margin scored with a crescent blade. The lesion was excised using Westcott scissors and carefully dissected from the corneoscleral surface using a Tooke blade and sponge-tip applicators. Residual pigment noted at the underlying limbus was excised en bloc with a beaver blade. Double freeze-thaw cryotherapy was then applied to the limbal and conjunctival margins, which were then closed with polyglactin 910 sutures.