title: Multi-layer amniotic membrane graft for pterygium in a patient with xeroderma pigmentosum.
abstract: BACKGROUND
  Xeroderma pigmentosum (XP) is a rare, autosomal recessive, premalignant condition of the skin, and is reported to be associated with ocular surface disorders such as conjunctival malignancy and pterygium. Herein, we report a case of successful management of pterygium with multi-layer amniotic membrane graft (AMG) in a young XP patient.
  
  
  METHODS
  An 11-year-old Japanese girl, who had been diagnosed as having XP, was referred to us for treatment of her bilateral pterygium. Surgical intervention was attempted for a temporal, presumably fast-growing pterygium in her left eye. Multi-layer amniotic membrane grafting was performed.
  
  
  METHODS
  The surgery-induced pain and irritation disappeared within a day. The limbal conjunctival autograft survived on the AMG and re-epithelialization over the AMG was completed in 2 weeks. Best corrected visual acuity improved from 20/32 to 20/16 one month postoperatively. During the 1-year follow-up period, no recurrence was noted.
  
  
  CONCLUSIONS
  The present case exemplifies that AMG as an adjunct to primary pterygium resection is effective even in a young patient with XP. In addition, multi-layer AMG, which we first demonstrated in this report, seems to be useful for protecting bare sclera and extraocular muscles from mechanical injury.
authors.affiliation: Department of Ophthalmology, Kanazawa University School of Medicine, Kanazawa, Ishikawaken, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Shirao
authors.forename: Y
authors.initials: Y
authors.lastname: Segawa
authors.forename: T
authors.initials: T
authors.lastname: Higashide
authors.forename: S
authors.initials: S
authors.lastname: Miwa
authors.forename: K
authors.initials: K
authors.lastname: Kawasaki
authors.forename: M
authors.initials: M
authors.lastname: Takata
authors.forename: S C
authors.initials: SC
authors.lastname: Tseng
mesh_terms: D000650:Amnion / Q000637:transplantation*; D002648:Child; D005260:Female; D006085:Graft Survival; D006801:Humans; D011625:Pterygium / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity; D014983:Xeroderma Pigmentosum / Q000150:complications / Q000601:surgery*