Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"


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Abstract
Abstract

Simultaneous Amniotic Membrane Transplantation in High-risk Keratoplasty

Seitz B., Sauer R., Hofmann-Rumelt C., Wenkel H., Langenbucher A., Naumann G. O. H.
Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany

Purpose: With limbal stem cell insufficiency (e.g. aniridia) or chronic polyarthritis (cP) epithelial healing problems after penetrating keratoplasty (PK) (especially à chaud) are common. The amniotic membrane (AM) is supposed to promote re-epithelialization, and to have antiinflammatory and antiangiogenic properties. In an experimental study it was further shown, that the AM itself is an immunprivileged tissue and may transfer this property to co-transplanted corneas, thus considerably decreasing their alloimmunogenity. The purpose of this study was to investigate the short- and intermediate-term results of simultaneous AM transplantation (AMT) in high-risk keratoplasties.
Method: From 01/2001 to 02/2003 a simultaneous AM-Patch (diameter 14 to 16 mm) was sutured episclerally in 16 patients (9 males, age 38 to 92 (73±14) years) directly following PK (diameter 3.5 mm eccentric to 8.0 mm central). In 13 eyes a soft contact lens was applied intraoperatively. Diagnoses included: 5x cP or Sjögren's syndrome, 4x bacterial ulcer with hypopyon, 2x ulcerative herpetic keratouveitis, 2x limbal stem cell insufficiency (aniridia or trauma), 1x ocular pemphigoid, 1x candida endophthalmitis and 1x acute stromal graft rejection with melting. Out of 14 eyes with emergency keratoplasties (à chaud), 10 corneas were perforated. Five patients received systemic


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