Amniotic Membrane Transplantation for Persistent Corneal Epithelial Defect and Ulceration

Abstract

Purpose: To report a case of one large persistent epithelial defect and ulceration treated with amniotic membrane transplantation. Methods: A 68-year-old woman, who underwent penetrating keratoplasty in both eyes 10 years previously, suffered from blurred vision and a painful sensation in her right eye in September 2005. She attended a local clinic, where corneal abrasion in the right eye was noted and topical antibiotics were prescribed. Because of exacerbated symptoms, she visited our department on October 28, 2005, that a corneal ulcer with a stromal abscess was noted. After two weeks of fortified antibiotic treatment, the corneal ulceration was controlled, but the persistent epithelial defects were unhealed. On December 8, 2005, corneal ulcer debridement and amniotic membrane transplantation were performed to manage the persistent corneal epithelial defects and ulceration. Results: The patient's preoperative visual acuity of the right eye was 6/60, whereas six months after surgery, her visual acuity was 6/20 without correction. At the six-month follow-up, the patient appeared to have a relatively clear graft with a stable scar over the lower temporal region. Corneal epithelial integrity was retained and corneal transparency was maintained. Conclusion: Amniotic membrane transplantation represents a viable approach to the management of persistent corneal epithelial defects with ulceration refractory to conventional medical treatment in the patient with healthy residual limbal stem cells.