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Successful visual rehabilitation with penetrating keratoplasty and doughnut amniotic membrane transplant for corneal scarring in advanced Mooren's ulcer

A 37-year-old one-eyed woman presented with a 3-month history of active Mooren's ulcer in her right eye. Conjunctival resection with tissue adhesive and bandage contact lens was performed thrice, despite which the eye progressed to total vascularized corneal scarring. After control of inflammation with systemic corticosteroids and immunomodulators, 10 months later she underwent penetrating keratoplasty with amniotic membrane transplant and tarsorrhaphy. At 2-year follow-up, the graft remained clear with no disease recurrence. This case highlights the modified surgical technique and the role of systemic immunosuppression while planning keratoplasty to achieve a successful outcome in end-stage Mooren's ulcer.