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Surgical Resection and Amniotic Membrane Transplantation for Treatment of Refractory Giant Papillae in Vernal Keratoconjunctivitis

Guo, Ping MD; Kheirkhah, Ahmad MD; Zhou, Wei-wei MD; Qin, Lei MD; Shen, Xiao-li MD

doi: 10.1097/ICO.0b013e31826a1e53
Clinical Science

Purpose: The aim of this study was to evaluate the outcome of surgical resection and amniotic membrane transplantation (AMT) for treatment of refractory symptomatic giant papillae in vernal keratoconjunctivitis (VKC).

Methods: This is a retrospective study of 13 eyes of 9 patients with refractory giant papillae associated with corneal shield ulcer and/or punctate epithelial erosions who underwent surgical resection of the papillae combined with AMT to cover the tarsal conjunctival defect.

Results: During 14.2 ± 4.2 months of postoperative follow-up, smooth tarsal conjunctival surface was achieved in all cases, with no recurrence of the giant papillae in any eye. Corneal shield ulcers and punctate epithelial erosions healed within 2 weeks after surgery and did not recur during the follow-up. Best-corrected visual acuity improved from 0.26 ± 0.21 logarithm of the minimum angle of resolution preoperatively to 0.02 ± 0.04 logarithm of the minimum angle of resolution postoperatively (P = 0.01). Three patients experienced recurrence of VKC symptoms, but without giant papillae, which could be well controlled by topical medications.

Conclusions: Surgical resection combined with AMT is an effective procedure for treatment of refractory giant papillae in patients with VKC.

*Department of Ophthalmology, Shenzhen Eye Hospital, Jinan University, Shenzhen, China

Ocular Surface Research and Education Foundation, Miami, FL

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Reprints: Ahmad Kheirkhah, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Sq, South Kargar St, Tehran, Iran 13366-16351 (e-mail:

The authors have no financial interest in any of the materials or methods mentioned in this study.

Received January 20, 2012

Accepted July 15, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.