Treatment of large conjunctival nevus by resection and reconstruction using amniotic membrane

  • Machiko Tomita
  • Hiroshi Goto
  • Ryuji Muramatsu
  • Masahiko Usui
Case Report



Nevus of the bulbar conjunctiva is a benign pigmented lesion of the ocular surface. Unless a biopsy is required for ruling out malignant melanoma, a nevus is usually excised for cosmetic reasons only. However, with large lesions involving two or more quadrants of the bulbar conjunctiva, a total resection can be difficult. In this report, we present a case of a huge nevus treated by surgical excision and amniotic membrane transplantation for reconstruction of the bulbar conjunctiva.


A 54-year-old Japanese man was referred to our clinic with suspected malignant tumor of the bulbar conjunctiva in his right eye. A large and diffuse pigmented tumor with numerous small cysts was present mainly on the upper bulbar conjunctiva. Resection of the conjunctival tumor and amniotic membrane transplantation for reconstruction of the bulbar conjunctiva were performed.


The histopathological diagnosis was conjunctival nevus. Epithelialization of the bulbar conjunctiva over the amniotic membrane sheet was completed 4 weeks after resection. At 44-month follow-up, there was no recurrence or any postoperative complication.


Surgical resection combined with reconstruction by amniotic membrane transplantation is effective for the treatment of large conjunctival nevus.


Conjunctive Amniotic membrane Nevus 


  1. 1.
    Folberg R, Jakobiec FA, Bernardino VB, Iwamoto T (1989) Benign conjunctival melanocytic lesions. Clinicopathologic features. Ophthalmology 96:436–461PubMedGoogle Scholar
  2. 2.
    Goto H, Usui M, Ishii I (2001) Efficacy of 123N-isopropyl-p-123I-iodoamphetamine single photon emission computed tomography for the diagnosis of uveal malignant melanoma. Am J Ophthalmol 132:937–939CrossRefPubMedGoogle Scholar
  3. 3.
    Goto H, Usui M, Wakamatsu K, Ito S (2001) 5-S-Cysteinyldopa as diagnostic tumor marker for uveal malignant melanoma. Jpn J Ophthalmol 45:538–542CrossRefPubMedGoogle Scholar
  4. 4.
    Jakobiec FA, Folberg R, Iwamoto T (1989) Clinicopathologic characteristics of premalignant and malignant melanocytic lesions of the conjunctiva. Ophthalmology 96:147–166PubMedGoogle Scholar
  5. 5.
    Paridaens D, Beekhuis H, van Den Bosch W, Remeyer L, Melles G (2001) Amniotic membrane transplantation in the management of conjunctival malignant melanoma and primary acquired melanosis with atypia. Br J Ophthalmol 85:658–661CrossRefPubMedGoogle Scholar
  6. 6.
    Scheffer C, Tseng SC, Prabhasawat P, Lee SH (1997) Amniotic membrane transplantation for conjunctival surface reconstruction. Am J Ophthalmol 124:765–774PubMedGoogle Scholar
  7. 7.
    Shields CL, Shields JA, Armstrong T (2001) Management of conjunctival and corneal melanoma with surgical excision, amniotic membrane allograft, and topical chemotherapy. Am J Ophthalmol 132:576–578CrossRefPubMedGoogle Scholar
  8. 8.
    Tan DTH, Ang LPK, Beuerman RW (2004) Reconstruction of the ocular surface by transplantation of a serum-free derived cultivated conjunctival epithelial equivalent. Transplantation 77:1729–1734CrossRefPubMedGoogle Scholar
  9. 9.
    Tseng SC (2001) Amniotic membrane transplantation for ocular surface reconstruction. Biosci Rep 21:481–489CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Machiko Tomita
    • 1
  • Hiroshi Goto
    • 1
  • Ryuji Muramatsu
    • 1
  • Masahiko Usui
    • 1
  1. 1.Department of OphthalmologyTokyo Medical UniversityTokyoJapan

Personalised recommendations