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Management of Ulcerative Herpetic Keratitis with Amniotic Membrane Transplantation

1Heiligenhaus A., 2Meller D., 1Li H., 2Hernandez Galindo E. E., 3Steuhl K. P.,
1St. Franziskus-Hospital, Augenabteilung (Münster)
2Universität-Gesamthochschule Essen, Zentrum für Augenheilkunde (Essen)
3Universität-Gesamthochschule Essen, Zentrum für Augenheilkunde, Abt. für Erkrankungen des vorderen Augenabschnitts (Essen)

Purpose: It has been shown recently that amniotic membrane transplantation (AMT) has anti-inflammatory action when used as a patch in mice with ulcerating herpetic keratitis. The authors now report the improvement of ulcerating herpetic keratitis in patients with AMT.
Method: In 5 patients with ulcerative herpetic stromal keratitis, human AM with epithelium facing up was transplanted. A single- or multilayer-technique of AMT was applied, and systemic aciclovir was used. The healing of the ulcers and the decrease of stromal inflammation was analyzed retrospectively.
Results: Improvement of stromal inflammation was noted within 17.4 days (range 7-28 days). Epithelial defects healed within teh mean of 17.8 days (range 7-22 days). Vision improved in all cases. Amniotic membrane transplantation was performed once in 2 cases, and twice in further three. Beside one recurrent herpetic keratitis, no serious side effects occurred.
Conclusions: The oberservations indicate that ulcerative herpetic keratitis can be improved with amniotic membrane transplantation in selected cases. Possible action mechanisms are discussed.

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