Repeat Amniotic Membrane Transplantation for Persistent or Recurrent Corneal Ulcers
Sauer R., Seitz B., Hofmann-Rummelt C., Langenbucher A., Naumann G. O. H.
Eye Clinic University Erlangen-Nürnberg, Erlangen
Purpose: The purpose of this study was to evaluate the results of repeat amniotic membrane transplantation (re-AMT) in patients with failure or recurrence after primary amniotic membrane transplantation (AMT) in therapy resistant corneal ulcers.
Method: 150 first AMT were performed between June 1999 and February 2003 for therapy resistant corneal ulcers. In 21 eyes (14%) of 20 patients (14 male, age 39 to 92 (59 ± 15) years) a second or third (2 patients) AMT was necessary from January 2000 to February 2003. From this group 12 re-AMTs were performed because of recurrence and 9 because of primary failure (i.e. no epithelialization during 4 weeks) of the first AMT. Both of the re-re-AMT were necessary due to recurrences. The diagnosis were: 10x herpetic corneal ulcers (5x with calcification), 2x marginal corneal ulcer with chronic polyarthritis, 2x ocular pemphigoid (1x bacterial ulcer), 1x Sjögren's syndrome, 1x limbal stem cell insufficiency with aniridia, 1x zoster ophthalmicus, 1x mycotic corneal ulcer, 1x acanthamoeba keratitis, 1x graft versus host reaction with atypical corneal band degeneration and 1x vascularized scars due to chemical burn. In 6 patients a patch was performed, 6x a (multi-) graft, and 10x a "sandwich". The follow-up after re-AMT ranged from 1.5 to 38 (17 ± 8) months.
Results: The corneal defect had a medium length of 4.4 ± 1.9
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