Moderate-to-severe DED with inadequate response to artificial tears and/or cyclosporine or lifitegrast. Presence of corneal staining (Oxford grade 2+) or persistent symptoms despite medical therapy.

Active ocular infection, known allergy to amniotic tissue, inability to comply with wear instructions.

After failure of at least one topical anti-inflammatory agent. Can be used concurrently with ongoing medical therapy.

Significant symptom reduction and corneal staining improvement in 70–80% of patients at 1-month follow-up.

Any patient with documented RCE — acute episode or history of recurrence. Eclipse is effective both for acute treatment and as prophylaxis after epithelial debridement.

Active stromal infection, uncontrolled IOP, known allergy.

Acute: apply at presentation after debridement. Prophylactic: apply after anterior stromal puncture or diamond burr polishing.

Epithelial closure in 5–7 days. Recurrence rate significantly reduced at 6-month follow-up.

Stage 2 NK (persistent epithelial defect with smooth rolled edges, reduced corneal sensation). Stage 3 NK may require surgical AMT. Concurrent cenegermin (Oxervate) appropriate.

Active herpetic disease, uncontrolled infection.

After confirming no active viral replication. Can be initiated concurrently with cenegermin.

Epithelial closure in 2–4 weeks in most stage 2 cases. Corneal sensation may partially recover over 3–6 months.

Any PED not responding to standard therapy (lubricants, BCL, tarsorrhaphy). Aurora preferred for central defects; Eclipse for peripheral or larger defects.

Active infection, uncontrolled systemic disease contributing to PED.

After 2+ weeks of failed conservative therapy.

Closure in 7–14 days in most cases. Repeat application may be needed for large or chronic defects.

Ramsay grade I–III chemical or thermal injury. Apply in acute phase after irrigation and pH normalization. Grade IV injuries may require surgical AMT.

Uncontrolled systemic injury, inability to monitor.

As soon as possible after pH normalization — within hours of injury for best outcomes.

Reduced inflammation, faster re-epithelialization, and lower risk of limbal stem cell compromise compared to standard therapy.

Grade II–IV pterygium requiring surgical excision. Tetra used for conjunctival defect closure following bare sclera excision.

Active ocular surface infection.

Intraoperative — applied immediately following pterygium excision.

Recurrence rate significantly lower than bare sclera excision alone. Comparable to conjunctival autograft in most studies.