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Surgical steps of the modified Gundersen flap using palpebral-bulbar conjunctiva. (A) The inferior palpebral conjunctival dissection is initiated, (B) extending to the inferior bulbar conjunctiva, (C) and further medially and laterally. (D) A conjunctival peritomy is created. (E) A mucous membrane graft is secured to the inferior palpebral area using Tisseel glue. The modified Gundersen flap is mobilized to cover the cornea, (F) and secured in place with 8–0 vicryl sutures.
