Fresh Amniotic Membrane Transplantation Combined Lamellar Keratoplasty for Patients with Recurrent Mooren's Ulcer

Purpose: To investigate the possibility of amniotic membrane as an immunologicalinsulating band to reduce the recurrent frequency of Mooren's ulcer.Methods: Twelve cases(12 eyes)with recurrent Mooren's Ulcer were observed. Amongthem, 4 cases(4 eyes)were male and 8 cases(8 eyes) female, ranging in age between 26and 51 years[mean(41 ± 3)years]. Three eyes recurred once, 5 eyes twice, and 4 eyesthree before. Eleven of 12 cases (11/12 eyes)with frequently recurrent Mooren's ulcerunderwent lamellar keratoplasty combined amniotic membrane transplantation(AMT).One patient who had entire corneal ulceration accepted AMT alone.Results: Follow-up time is 12 to 29 months, [mean (23 ± 6) months]. Before AMT, therecurrent frequency of Mooren's Ulcer of all cases after corneal surgery was 1 ～ 7 months[mean(3 ± 2)months]. Nine of 12 eyes with lamellar keratoplasty combined AMT did notrecur within the observation period; 2 eyes recurred 11 months after the surgery. Threemonths postoperatively, neovascularization was observed, which made it nearly impossibleto decipher between amniotic membrane and its nearby conjunctiva, only at the junctionof the transplant can some trails be observed. One case with entire AMT alone showedgraft resolution and neovascularization in 1 month.Conclusion:AMT combined with lamellar keratoplasty and lesion excision may delayrecurrence of Mooren's Ulcer, reduce its recurrent frequency. Besides the effects ofdecreasing inflammation, it may have immunological insulating function as well. Thisconclusion should be proven by further clinical comparative study of much moresamples.

Purpose: To investigate the possibility of amniotic membrane as an immunological insulating band to reduce the recurrent frequency of Mooren's ulcer. Methods: Twelve cases(12 eyes) with recurrent Mooren's Ulcer were observed. Among them, 4 cases(4 eyes)were male and 8 cases(8 eyes)female, ranging in age between 26 and 51 years [mean (41 ±3) years]. Three eyes recurred once, 5 eyes twice, and 4 eyes three before. Eleven of 12 cases (11/12 eyes) with frequently recurrent Mooren's ulcer underwent lamellar keratoplasty combined amniotic membrane transplantation (AMT) . One patient who had entire corneal ulceration accepted AMT alone. Results: Follow-up time is 12 to 29 months, [mean (23 ±6)months]. Before AMT, the recurrent frequency of Mooren's Ulcer of all cases after corneal surgery was 1-7 months [ mean (3 ± 2) months ]. Nine of 12 eyes with lamellar keratoplasty combined AMT did not recur within the observation period; 2 eyes recurred 11 months after the surgery. Three months postoperatively, neovascularization was observed, which made it nearly impossible to decipher between amniotic membrane and its nearby conjunctiva, only at the junction of the transplant can some trails be observed. One case with entire AMT alone showed graft resolution and neovascularization in 1 month. Conclusion : AMT combined with lamellar keratoplasty and lesion excision may delay recurrence of Mooren's Ulcer, reduce its recurrent frequency. Besides the effects of decreasing inflammation, it may have immunological insulating function as well. This conclusion should be proven by further clinical comparative study of much more samples. Eye Science 2003; 19: 1-5.