Amniotic membrane transplantation for Mooren's ulcer.

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.