Relapsing Mooren's ulcer after amniotic membrane transplantation combined with conjunctival autografting.
OBJECTIVE
To report a patient with Mooren's ulcer that relapsed 2 months after amniotic membrane (AM) transplantation and conjunctival autografting and its subsequent retreatment.


METHODS
Interventional case report.


METHODS
We performed multilayered AM transplantation and conjunctival autografting from the opposite healthy eye to treat a corneoscleral perforation caused by Mooren's ulcer in a 60-year-old woman.


METHODS
Reformation of the anterior chamber, absence of inflammation, and restoration of visual acuity.


RESULTS
The perforated corneoscleral lesion was sealed successfully by the AM and conjunctiva graft and led to a stable condition for 2 months. Relapsing corneal edema, keratic precipitates, and cell infiltration occurred along the margin of the conjunctival graft with severe vessel engorgement. After removing the conjunctival graft and regrafting of additional AM, the lesion subsided for at least 1 year.


CONCLUSIONS
Amniotic membrane transplants may be useful in treating corneal perforation of immunologic origin, but conjunctiva and its vessels may play a role in the process of peripheral corneal destruction of Mooren's ulcer.
Chen
Ko-Hua
KH
Department of Ophthalmology, Taipei Veterans General Hospital, 201 Shih-Pai Road, Section II, Taipei, Taiwan 11217, R.O.C. khchen@vghtpe.gov.tw
Hsu
Wen-Ming
WM
Liang
Chih-Kai
CK
D000650:Amnion / Q000637:transplantation*; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000637:transplantation*; D003320:Corneal Ulcer / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D014182:Transplantation, Autologous; D014792:Visual Acuity