Conjunctival healing after amniotic membrane graft over ischemic sclera

Purpose: To present a case of chemical injury associated with calcification and severe conjunctival and scleral ischemia, in which tissue regeneration was achieved using an amniotic membrane graft. Methods: A 65-year-old man presented to our department 8 weeks after suffering a chemical injury of his left eye with sulfuric acid. There was extensive calcification of the cornea and conjunctiva, associated with severe ischemia of the adjacent sclera. After resection of the calcified tissue and nonviable tissue, amniotic membrane was grafted to cover the extensive zone of scleral ischemia. Results: In the weeks following grafting, slow epithelialization and revascularization was observed over the amniotic membrane, stemming from the surrounding healthy conjunctiva. Conclusion: Although the presence of ischemia at the base of the graft has been considered a contraindication for amniotic membrane transplantation, this case demonstrates that, provided that the surrounding tissue is not affected, a graft may be useful. In such cases an amniotic membrane graft could be attempted before other alternatives, such as conjuntival or oral mucosal autografts.