Amniotic membrane transplantation for Mooren's ulcer

Clin Exp Ophthalmol. 2011 Jul;39(5):386-92. doi: 10.1111/j.1442-9071.2010.02479.x. Epub 2011 Mar 16.

Abstract

Background: To describe the outcome of surgery using amniotic membrane transplantation for Mooren's ulcer.

Design: A prospective interventional case series from the Vietnam National Institute of Ophthalmology.

Participants: Eighteen eyes of 14 patients with Mooren's ulcer. Seven eyes had recurrent episodes of ulceration, and 11 were not responsive to medical therapy or conjunctival resection.

Methods: All eyes were treated with amniotic membrane grafts for Mooren's ulcer (10 eyes with multilayer grafts; 8 with a single layer graft). Five eyes with a 360° peripheral ulcer were treated with an overlay amniotic membrane graft, and 13 eyes were treated with a freehand graft tailored to fit the localized defect.

Main outcome measures: Time to epithelial healing. Visual acuity outcome.

Result: Sixteen of 18 eyes were treated by a single surgery with amniotic membrane with rapid healing of the epithelial defect (mean time to complete epithelialization 12.4 days). Two eyes required a second amniotic membrane graft: one eye required regrafting following a subgraft haemorrhage and another eye required regrafting for a persistent epithelial defect. Vision was stabilized in all eyes with 10 of 18 eyes obtaining vision of 6/12 or better.

Conclusion: Amniotic membrane transplantation may be a useful treatment for selected patients with Mooren's ulcer especially where systemic immunosuppressive drugs are unavailable.

MeSH terms

  • Adult
  • Aged
  • Amnion / transplantation*
  • Biological Dressings*
  • Corneal Ulcer / physiopathology
  • Corneal Ulcer / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Reoperation
  • Treatment Outcome
  • Visual Acuity / physiology
  • Wound Healing / physiology