Lamellar Keratoplasty and Amniotic Membrane Transplantation in Morbus Bowen
Walter S., Behrens-Baumann W.
Department of Ophthalmology, Otto-von-Guericke Universitity, Magdeburg
Purpose: Pre-canceroses lesions are modifications of the conjunctiva and cornea, which are clinical similar carcinomas and untreated often convert into a solid carcinoma.
Patient: A 82-year-old patient was seen in our Department because of a large conjunctival - corneal tumor at the left eye. 3 years before the patient underwent cataract surgery combined with a pterygium surgery at this eye at a different hospital (histologically confirmed).
Results: Biomicroscopy revealed a big tumor infiltrating from the caruncle both nasal quadrants towards the center of the cornea. Visual acuity of the left eye was 0.1 cc. Surgical management included a tumorexcision, a lamellar keratoplasty (diameter 10mm) and an amniotic membrane transplantation in the field of the large conjunctival defect. Visual acuity increased afterwards to 0.2 cc. The histological diagnosis revealed a squamous cell carcinoma which was removed in situ (Morbus Bowen).
Conclusions: The combination of lamellar keratoplasty and amniotic membrane transplantation allowed the preservation of the bulbus. In lesions with large conjunctival defects, the use of amniotic membranes as a basal membrane seems to guarantee a rapid epithelialization. Therefore this technique allows to expand the spectrum of surgical interventions for surface reconstruction of the eye.
Zurück | Back