Amniotic membrane transplantation for ocular surface reconstruction in patients with chemical and thermal burns.
OBJECTIVE
The purpose of the study is to examine the usefulness of preserved human amniotic membrane transplantation in patients with chemical and thermal burns.


METHODS
The study design was a nonrandomized clinical trial.


METHODS
Seven eyes of six patients with severe chemical (n = 5) and thermal (n = 2) burns were studied.


METHODS
Eyes were treated with excision of cicatricial tissues followed by a placement of amniotic membrane on the sclera. Transplantation of limbal grafts from an opposite eye (n = 4) or from donor eyes preserved at -80 degrees C (n = 2) was performed simultaneously.


METHODS
Reconstruction of ocular surface epithelia and visual acuity were measured.


RESULTS
With the mean observation period of 53.3 weeks, central corneal epithelium was reconstructed successfully in all eyes. Neither amniotic membrane nor limbal grafts were rejected. A persistent epithelial defect developed in one eye, which was treated successfully by tarsorrhaphy. After surgery, the corneal epithelium showed normal arrangements on specular microscopy, and its barrier function recovered to seminormal. Corrected visual acuity markedly improved in each eye. Regenerated conjunctiva on the amniotic membrane was stable and uninflammed with minimum-to-mild scarring. Slight recurrence of conjunctivalization was noted in three eyes. However, because these eyes were stable and central cornea was clear, no further surgery was needed.


CONCLUSIONS
Amniotic membrane transplantation promotes normal conjunctival epithelialization while suppressing fibrosis formation. The procedure, especially when performed with limbal autograft transplantation, appears to be effective for the treatment of chemical or thermal burns of the ocular surface.
Shimazaki
J
J
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
Yang
H Y
HY
Tsubota
K
K
D000293:Adolescent; D000328:Adult; D000650:Amnion / Q000637:transplantation*; D002057:Burns, Chemical / Q000473:pathology / Q000601:surgery*; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D065306:Corneal Injuries; D015925:Cryopreservation; D019573:Epithelium, Corneal / Q000502:physiology; D005126:Eye Burns / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D015590:Fluorophotometry; D006358:Hot Temperature; D006801:Humans; D016850:Limbus Corneae / Q000601:surgery; D008297:Male; D008566:Membranes / Q000637:transplantation; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012590:Sclera / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D014021:Tissue Preservation; D014792:Visual Acuity; D014945:Wound Healing