Multilayer amniotic membrane transplantation in severe ocular graft versushost disease

PURPOSE. TO clarify the usefulness of multilayer amniotic membrane transpla ntation in an unusual case of calcareous corneal degeneration in a patient with graft-versus-host disease. METHODS. A 20-year-old Caucasian woman had bilateral calcareous corneal deg eneration of one year of evolution, secondary to graft-versus-host disease. Treatment for both eyes with topical steroids and antibiotic ointment was not successful. Right eye had a spontaneous corneal perforation, and a thre e-layer circle amniotic membrane graft was applied to the whole cornea. RESULTS. During a follow-up period of 20 months we observed stability of th e corneal epithelium and stroma. The amniotic membrane-covered area showed rapid epithelization, reduced inflammation and suppressed fibrosis formatio n. CONCLUSIONS. Multilayer amniotic membrane transplantation may be considered an alterantive for reconstructing the ocular surface in a patient with sev ere dry eyes and calcareous corneal degeneration, even with little perforat ion.