Comprehensive Management of Mooren’s Ulcer with Conjunctival Resection and Double-Layer Amniotic Membrane Transplantation: A Case Report

Mooren’s ulcer is a rare, progressive peripheral corneal inflammatory disease that may lead to vision loss due to corneal destruction. The disease is thought to be associated with an autoimmune mechanism without clear evidence of infectious causes or systemic disease involvement. Its management remains challenging, particularly in progressive cases, with a combination of conjunctival resection and Amniotic Membrane Transplantation (AMT) serving as one of the therapeutic options to control inflammation and preserve corneal integrity. A 23-year-old woman presented with severe pain in her left eye for approximately 3 weeks, accompanied by redness, epiphora, photophobia, foreign body sensation, and decreased visual acuity. The patient had previously been diagnosed with corneal ulcer and had received initial treatment without clinical improvement. Ophthalmological examination revealed a left eye visual acuity of 1/300, intraocular pressure of 8 mmHg, and a peripheral corneal ulcer with stromal excavation extending from the 9 to 15 o’clock position, accompanied by superior conjunctivalization. There was no history of ocular trauma, contact lens use, previous ocular infection, or systemic autoimmune disease. The patient was diagnosed with Mooren’s ulcer with a differential diagnosis of Peripheral Ulcerative Keratitis (PUK) and underwent conjunctival resection combined with Double-Layer Amniotic Membrane Transplantation (AMT). Postoperative evaluation showed that the amniotic membrane was well-positioned with adequate apposition, and the patient received further treatment consisting of antibiotics, corticosteroids, topical immunomodulators, and ocular lubricants.