title: Amniotic membrane transplantation for reconstruction of corneal ulcer in graves ophthalmopathy.
abstract: OBJECTIVE
  To report one case of corneal ulceration associated with a severe manifestation of Graves ophthalmopathy that was treated with amniotic membrane (AM) transplantation using the inlay and overlay technique.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 40-year-old woman with Graves ophthalmopathy had a corneal ulcer on the left eye refractory to topical treatment and orbital decompression surgery. Severe Graves ophthalmopathy was characterized by tear film instability, lagophthalmus, and reduced Bell phenomenon. After amniotic membrane transplantation the epithelial and stromal defect healed quickly with improvement of visual acuity and within the dissolution period of the overlay AM.
  
  
  CONCLUSIONS
  Amniotic membrane transplantation is a successful and alternative approach to treat severe corneal surface disorders refractory to medical treatment in patients with Graves ophthalmopathy. Besides having an anti-inflammatory action mechanism, the overlay AM used herein as a temporary patch was possibly functioning as a protective shield to ensure epithelialization of the AM used as a graft in the ulcer bed.
authors.affiliation: Department of Ophthalmology, University of Essen, Hufelandstr. 55, 45122 Essen, Germany. Carsten.Heinz@gmx.net
authors.forename: Carsten
authors.initials: C
authors.lastname: Heinz
authors.forename: Anja
authors.initials: A
authors.lastname: Eckstein
authors.forename: Klaus-Peter
authors.initials: KP
authors.lastname: Steuhl
authors.forename: Daniel
authors.initials: D
authors.lastname: Meller
mesh_terms: D000328:Adult; D000650:Amnion / Q000637:transplantation*; D001684:Biological Dressings; D002465:Cell Movement; D003320:Corneal Ulcer / Q000175:diagnosis / Q000601:surgery*; D019573:Epithelium, Corneal / Q000502:physiology; D005260:Female; D006111:Graves Disease / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D019651:Plastic Surgery Procedures; D014792:Visual Acuity; D014945:Wound Healing