Exploring new approaches in corneal surface reconstruction | YPG recap

The Eversight Young Physicians Group (YPG) kicked off 2026 with a virtual session focused on managing limbal stem cell deficiency (LSCD) and restoring the ocular surface. This session was led by returning forum lead Elliot Crane, MD, Northern New Jersey Eye Institute, and new leads Imane Tarib, MD, Wilmer Eye Institute, Johns Hopkins Medicine, Pauline Dmitriev, MD, University of Michigan Kellogg Eye Center, and Samera Ahmad, MD, Cook County Health, University of Illinois Chicago.

Ophthalmology residents, fellows and early-career surgeons joined for case-based discussions, emerging techniques and candid conversations about what works—and what doesn’t—in real-world practice.

Disclaimer: Medical information is not medical advice—read our disclaimer. 

BrightMEM in practice: Promise and limitations in LSCD

A central focus of the meeting was BrightMEM by Brightstar Therapeutics. Made from Descemet's membrane, it serves as an optimized substrate for protecting the stroma from degradation and promoting regeneration of the corneal epithelium.

Presenters highlighted its potential advantages:

• Promotes corneal re-epithelialization
• Supports limbal stem cell activity
• Provides an optically clear, durable scaffold

Compared to traditional amniotic membrane, BrightMEM may offer improved clarity and longer persistence on the ocular surface, making it an appealing option in select cases.

However, outcomes remain highly dependent on disease severity and the presence of viable limbal stem cells.

Key takeaways

• BrightMEM is a promising tool for ocular surface reconstruction, particularly in mild to moderate LSCD
• Success depends on residual stem cell function and inflammation control
• It may serve as a bridge—or adjunct—to more advanced procedures  

Case spotlight: Severe chemical injury and LSCD

Samera Ahmad, MD, Faculty, Cook County Health and University of Illinois Chicago, presented a challenging case of a 55-year-old patient with severe LSCD following a cement chemical injury.

Because the patient was hesitant to pursue limbal stem cell transplantation, the team opted for a more conservative surgical approach:

• Superficial keratectomy
• Symblepharon release and fornix reconstruction
• BrightMEM placement over the cornea

Initially, the results were encouraging with improved epithelialization, reduced light sensitivity and visual improvement from count fingers to pinhole acuity. However, by three months postoperatively, the disease recurred:

• Corneal opacification returned
• Neovascularization progressed
• Symblepharon reformed

Key takeaways

• BrightMEM may not be sufficient in advanced LSCD without viable stem cells
• Severe inflammation must be addressed before reconstruction
• Staged surgical approaches are often necessary

Combining techniques for better outcomes

Participants also explored how BrightMEM can be integrated with other surgical approaches:

• SLET (simple limbal epithelial transplantation) layered with BrightMEM
• The “ham sandwich” technique: cornea → BrightMEM → limbal tissue → amniotic membrane
• Use of KLAL-Pro as both a stem cell source and a physical barrier to inflammation
• Buccal mucosal grafts for complex ocular surface reconstruction   

Managing astigmatism after DALK

Elliot Crane, MD, Northern New Jersey Eye Institute, presented a case discussion on post-DALK astigmatism, highlighting another ongoing clinical challenge.

Key takeaways

• Astigmatism outcomes can shift unpredictably after suture removal
• Standard approaches (e.g., removing sutures along the steep axis) don’t always yield expected results
• Management options remain variable and include:
  • Arcuate keratotomy
  • Laser vision correction
  • Specialty contact lenses

The discussion underscored the importance of individualized management and setting realistic expectations. 

The value of peer collaboration

The most impactful aspect of the session was the open exchange of ideas. Participants shared:

• Surgical successes and failures
• Technique preferences and modifications
• Questions about complex cases still in progress

This collaborative environment reflects the mission of YPG: to provide a supportive space where early-career surgeons can learn from one another and grow together.

Looking ahead

As new technologies like BrightMEM continue to evolve, forums like the Eversight Young Physicians Group remain essential for bridging innovation and clinical practice.

By sharing real-world experiences and engaging in thoughtful discussion, young physicians are shaping the future of corneal care—one case at a time.

The next YPG meeting is Tuesday, July 14. Have a case or question to share? Submit it in advance and be a part of the conversation.