It is the purpose of this thesis to present a broad program for the management of total xerophthalmia based on ten years' experience and follow-up of patients. The evolution of this program will be presented with emphasis on the changes in surgical technique and management. The objective of these modifications is to minimize complications and to insure the best possible long-term result. It is hoped that this presentation including surgical techniques, management of complications, and details of the overall program may serve as a basis for the ophthalmologist faced with the problems inherent in the management of total xerophthalmia.