Migration of Limbal Melanocytes Onto the Central Cornea After Ocular Surface Reconstruction: An In Vivo Confocal Microscopic Case Report

Abstract

To report the in vivo confocal microscopic findings of migrated melanocytes onto the central cornea in a patient with Stevens-Johnson syndrome who received ocular surface reconstruction by amniotic membrane transplantation (AMT). Single interventional case report. A 37-year-old man presented with bilateral symblepharon because of Stevens-Johnson syndrome. Release of the bilateral symblepharon with AMT on the bare sclera was performed. Three weeks after the surgery, slit-lamp biomicroscopy of the right eye revealed patchy brown pigmentation on the surface of the cornea and the amniotic membrane transplanted to the bare sclera. In vivo confocal microscopy of the affected cornea revealed abnormal basal epithelial cells with hyperreflective nuclei and loss of cellular borders. Multiple dendritiform cells, which appeared to be melanocytes, were distributed mainly on the corneal basal epithelial layer and superficial stroma. The number of the migrated melanocytes gradually decreased over 6 months of observation. Melanocytes can migrate into the central cornea after reconstruction of the ocular surface with AMT. In vivo confocal microscopy can be a useful tool to observe these changes.