Amniotic membrane transplantation in the management of shield ulcers of vernal keratoconjunctivitis

Purpose: To report our experience with amniotic membrane transplantation in the management of severe shield ulcers. Design: Retrospective, interventional, noncomparative case series. Participants: Four patients (seven eyes) with grade 2 (ulcer with opaque ba se) and grade 3 (plaquelike lesions) shield ulcers not responding to steroi d therapy with or without surgical debridement. Intervention: Amniotic membrane transplantation with stromal side down was performed after meticulous debridement of the ulcer. Main Outcome Measures: Healing of the ulcer with no epithelial defect. Results: The ulcers healed with disintegration or retraction of the membran e in all patients within 2 weeks. Conclusions: Amniotic membrane transplantation in combination with debridem ent is an effective surgical modality in the management of severe shield ul cers, Further studies are warranted to confirm the efficacy of amniotic mem brane transplantation in the management of shield ulcer and its correct pos ition in the treatment algorithm. Ophthalmology 2001;108:1218-1222 (C) 2001 by the American Academy of Ophthalmology.