97th DOG Annual Meeting 1999
P81
AMNIOTIC MEMBRANE TRANSPLANTATION WITH LIMBAL TRANSPLANTATION FOR CORNEAL SURFACE RECONSTRUCTION AFTER SEVERE THERMAL OR CHEMICAL BURNS.
J. Stoiber, J. Ruckhofer, E. Alzner, G. Grabner
Severe thermal and chemical burns may result in limbal deficiency leading to persistent epithelial defect, complete conjunctival epithelial ingrowth and vascularisation of the cornea. If sufficiently severe, these burns may lead to very significant visual impairment. Amniotic membrane transplantation with limbal transplantation has recently been proposed as a new method for corneal surface reconstruction.
Methods: 5 patients (all male, age from 18 to 53 years, mean age: 37 years) with limbal deficiency resulting from thermal (n=1) or chemical burns (n=4) underwent surgery. The corneal pannus was completely removed and amniotic membrane was grafted onto the cornea. Limbal transplantation using autografts obtained from contralateral eyes was performed simultaneously in 3 cases. Allografts from a donor were transplanted in two cases with bilateral involvement, patients received oral and topical cyclosporin A postoperatively.
Results: In all cases the corneal surface showed a complete and stable epithelialization within a few weeks. The initially semitransparent amniotic membrane became more translucent and biomicroscopically invisible within several months after surgery. There was an increase in visual acuity in all cases, limited only by irregular astigmatism due to the initial stromal loss.
Conclusions: Amniotic membrane transplantation with limbal transplantation allows reconstruction of the ocular surface severely damaged by chemical or thermal burns. In most cases, however, additional surgical procedures such as lamellar or penetrating keratoplasty are required for adequate visual rehabilitation.
Landesaugenklinik, LKA Salzburg, Müllner Hauptstr. 48, A-5020 Salzburg
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