PMC6067617_01
Initial slit-lamp image showing an 8 mm x 6 mm large pigmented lesion with numerous small cysts in the superior bulbar conjunctiva of the right eye.
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Upon examination, a large pigmented lesion with numerous small cysts was present on the superior bulbar conjunctiva (Figure 1).
(A) Color photograph of the surgical video after the application of topical anesthesia (five drops of a single dose of 0.4% oxybuprocaine hydrochloride). (B and C) Subconjunctival anesthesia with 2% mepivacaine. (D) The conjunctival tumor was resected using a wide excisional biopsy with a tumor safety distance of 2.0 mm. The resection was performed using the "no-touch" technique. (E) The 12 mm x 10 mm conjunctival defect. (F) The AM was placed with the stromal side facing down toward the defect. The AM was secured to the surrounding conjunctiva by five interrupted 9-0 Vicryl sutures.. Abbreviation: AM, amniotic membrane.
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For this case, an AMT using the inlay technique was applied, and the surgery is shown in Figure 2.
(A) Magnified slit-lamp image showing the pigmented lesion with numerous small cysts. (B) Histopathological slide of the tumor stained with H&E, x20. (C) Histopathological slide of the tumor stained with H&E, x50. Numerous nests of nevus cells containing abundant melanin pigment can be seen under the conjunctival epithelium.. Abbreviation: H&E, hematoxylin and eosin.
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Figure 3 shows the histopathological slides of the nevus stained with hematoxylin and eosin (x20 and x50 magnification), on which numerous nests of nevus cells containing abundant melanin pigment could be seen under the conjunctival epithelium.
Slit-lamp images showing the course of healing over time.. Notes: (A) Slit-lamp image showing the large pigmented lesion before surgery. (B) Seven days after the resection and AMT. (C) A slit-lamp examination revealed stable findings 6 months after surgery. The AM has been partly integrated into the host tissue, while the ocular surface inflammation and corneal vascularization have decreased.. Abbreviations: AM, amniotic membrane; AMT, AM transplantation.
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Figure 4 shows this eye's course of healing over time, in which a reduction in the inflammation and healing of the conjunctival defect could be seen.