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 base) and grade 3 (plaquelike lesions) shield ulcers not responding to steroid 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 membrane in all patients within 2 weeks. Conclusions: Amniotic membrane transplantation in combination with debridement is an effective surgical modality in the management of severe shield ulcers. Further studies are warranted to confirm the efficacy of amniotic membrane transplantation in the management of shield ulcer and its correct position in the treatment algorithm