J Korean Ophthalmol Soc.  2011 Oct;52(10):1232-1237. 10.3341/jkos.2011.52.10.1232.

Five-Layered Reinforcing Amniotic Membrane Transplantation for Treatment of Deep Corneal Ulcer or Perforation

  • 1Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea. jck50ey@kornet.net


To evaluate the efficacy of five-layered reinforced amniotic membrane (AM) transplantation for treating deep corneal ulcer or perforation.
We performed a five-layered reinforced AM transplant in three cases of corneal ulceration or perforation using mechanical compressed lyophilized AMs. In all cases, the perforated cornea healed with re-epithelization within 2 weeks and the ocular surface was stabilized for more than 1 year.
Five-layered reinforced AM transplantation may be an alternative method for treating deep corneal ulcers or perforations.


Amniotic membrane; Corneal perforation; Corneal ulcer

MeSH Terms

Corneal Perforation
Corneal Ulcer


  • Figure 1. Light microscopic findings of amniotic membrane. (A) Single-layered lyophilized AM, (B) 5-layered reinforced AM (hematoxylin-eosin, original magnification, ×200). AM = amniotic membrane.

  • Figure 2. Case 1 (A) Initial photographs. The cornea was perforated and the anterior chamber was shallow. (B) Anterior chamber was well formed and no epithelial defects were seen 18 months after 5-layered reinforcing AM trasplantation. Case 2 (C) Initial photographs. Corneal ulcer (2 × 3 mm) with peripheral opacity was seen preoperatively. (D) The ocular surface was stabilized until postoperative 5 months. Case 3 (E) Initial photographs. Corneal ulcer (5 × 5 mm) and total limbal deficiency with neovascularization were seen. (F) To prevent complication of exposure keratitis, tarsorrhaphy has been maintained until post operative 15 months.

  • Figure 3. Representative AS-OCT imaging of case 2. Recovery of corneal thickness and anterior chamber stability was showed with AS-OCT at 12 months after 5-layered reinforced AM transplantation. AS-OCT = anterior segment Optical coherence tomography; AM = amniotic membrane.

Cited by  1 articles

A Case of Tectonic Lamellar Corneal Patch Graft Using Acellular Cornea in Corneal Ulcer Perforation
Jong Yeop Park, Eok Soo Suh
J Korean Ophthalmol Soc. 2015;56(8):1278-1283.    doi: 10.3341/jkos.2015.56.8.1278.



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