Conjunctival resection with and without amniotic membrane graft for the treatment of superior limbic keratoconjunctivitis

Oscar Gris, Alicia Plazas, Enrique Lerma, José L. Güell, Laura Pelegrín, Daniel Elíes

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10 Citations (Scopus)


Purpose: To compare the efficacy of conjunctival resection versus conjunctival resection with amniotic membrane graft (AMG) in patients with superior limbic keratoconjunctivitis not responsive to medical therapies. Methods: In a retrospective and comparative study, 16 eyes of 9 patients with long-lasting superior limbic keratoconjunctivitis who were refractory to medical treatment were included. Conjunctival resection was performed in 8 cases, and conjunctival resection with AMG was performed in 8 cases. Subjective symptoms, biomicroscopic signs, and impression cytology were evaluated both pre-and postoperatively. Results: The mean follow-up period was 46 months, ranging from 1.5 to 6 years. After surgery, all cases undergoing conjunctival resection and 7 of 8 cases undergoing conjunctival resection with AMG remained asymptomatic. One case undergoing conjunctival resection with AMG experienced recurrence, requiring reoperation 2 years later (conjunctival resection without AMG). In this patient, complete disappearance of symptoms and signs was achieved during a 4-year period of follow-up after the second surgery. No intra-or postoperative complications were observed in either group. Preoperative impression cytology disclosed severe squamous metaplasia, and goblet cells were markedly decreased in all patients. Postoperative impression cytology 3 months after surgery did not show any significant improvement in squamous metaplasia in either of the groups. Conclusions: Conjunctival resection and conjunctival resection with AMG are effective and safe surgical procedures. Despite the potential benefits of the AMG, this procedure did not provide additional advantages in our study. © 2010 by Lippincott Williams & Wilkins.
Original languageEnglish
Pages (from-to)1025-1030
Issue number9
Publication statusPublished - 1 Sep 2010


  • amniotic membrane graft
  • conjunctival resection
  • superior limbic keratoconjunctivitis


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