Outcomes and Rationale of Excision and Mucous Membrane Grafting in Palpebral Vernal Keratoconjunctivitis

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To report outcomes of mucous membrane grafting (MMG) for refractory giant papillae in vernal keratoconjunctivitis.


Eleven eyes of 6 patients having giant papillae and recurrent shield ulcers refractory to topical medications, cryotherapy, and supratarsal steroid injections and shave excision of papillae underwent surgical resection of the giant papillae with MMG. Average occurrence of shield ulcers was twice per eye per year before the procedure with 50% of eyes having steroid-induced cataract and glaucoma.


No recurrence of the shield ulcer in any eye was observed over a mean follow-up period of 38.2 (range 9–106) months. The papillae recurred beyond the graft junction in one eye.


Surgical excision of refractory giant papillae followed by MMG does have its advantages in reducing their corneal complications, and it should be considered early in the management of exuberant refractory giant papillae.

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