Amniotic membrane transplantation for reconstruction of corneal ulcer in graves ophthalmopathy

OBJECTIVE: To report one case of corneal ulceration associated with a severe manifestation of Graves ophthalmopathy that was treated with amniotic membrane (AM) transplantation using the inlay and overlay technique. METHODS: Case report. RESULTS: A 40-year-old woman with Graves ophthalmopathy had a corneal ulcer on the left eye refractory to topical treatment and orbital decompression surgery. Severe Graves ophthalmopathy was characterized by tear film instability, lagophthalmus, and reduced Bell phenomenon. After amniotic membrane transplantation the epithelial and stromal defect healed quickly with improvement of visual acuity and within the dissolution period of the overlay AM. CONCLUSION: Amniotic membrane transplantation is a successful and alternative approach to treat severe corneal surface disorders refractory to medical treatment in patients with Graves ophthalmopathy. Besides having an anti-inflammatory action mechanism, the overlay AM used herein as a temporary patch was possibly functioning as a protective shield to ensure epithelialization of the AM used as a graft in the ulcer bed.