Petersen H., Spoerl E., Fruehauf A.

Universitäts-Augenklinik, Universitätsklinikum TU Dresden. Fetscherstr. 74, D-01307 Dresden

Transplantation of amniotic membrane is widely accepted for reconstruction of corneal surface, but the rapid degradation and resorption are limiting factors. A more resistant and durable membrane is desirable.
Methods and Patients: Immediately before transplantation fresh AM was crosslinked in a mixture of balanced salt solution, 0.1 % glutaraldehyde and 20 % Dextran T500 for a duration of 30 min. Experimentally the stressstrain- behaviour and the resorption time in pepsin solution were investigated. In 11 eyes with corneal ulceras and in one eye with extreme corneal thinning (newborn with Peter's anomaly) the crosslinked AM served as a coverage. The prepared AM was circularly fixed on bare sclera 3 - 5 mm peripheral to the limbus. Conjunctiva was fixed onto the membrane.
Results: Crosslinked AM showed an increased stress-strain-relation (factor 1.6) and less tendency to roll up. The resorption time in pepsin solution was determined for the untreated AM with 4 days and for the crosslinked one with 30 days. Clinically we observed during the follow-up time of 6 - 8 months a stability between 23 - 78 days (Mean = 46.6 days). In most cases the survival of AM was not limited by resolving of the AM, but by displacement due to suture insufficiency.
Conclusions: Crosslinked AM distinguished because of increased biomechanical stability by better handling and due to increased resistance against collagenolytic enzymes by a resorption time of several weeks. Any side effects were not observed.

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