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Amniotic membrane transplantation for Mooren's ulcer
Nguyen D Ngan1, Hoang T M Chau
1Department of Ophthalmology, Vietnam Military Medical University, Hanoi, Vietnam.
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.
