Amniotic membrane transplantation for partial limbal stem cell deficiency.
OBJECTIVE
To examine the efficacy, safety, and long term outcomes of amniotic membrane transplantation for corneal surface reconstruction in cases of partial limbal stem cell deficiency.


METHODS
17 eyes of 15 patients with partial limbal stem cell deficiency underwent superficial keratectomy of the conjunctivalised corneal surface followed by amniotic membrane transplantation. Cases were followed up for at least a year.


RESULTS
All eyes exhibited a stable, intact corneal epithelial surface after a mean follow up period of 25.8 months with no eyes developing recurrent erosion or persistent epithelial defect. The mean time to re-epithelialisation was 22.8 days. Overall improvement in visual acuity was observed in 92.9% of 14 eyes with visual potential. Of those, five eyes gained six or more lines, two eyes gained between four and five lines, six eyes gained between one and three lines, and one eye lost three lines of Snellen acuity. Pain and photophobia were abolished in 86% of cases and substantially reduced in 14%, with all eyes exhibiting decreased vascularisation and inflammation at final follow up.


CONCLUSIONS
Amniotic membrane transplantation appears to be a safe and effective method of restoring a stable corneal epithelium for cases of partial limbal stem cell deficiency and can be considered as an alternative to limbal autograft or allograft.
Anderson
D F
DF
Ocular Surface and Tear Center, Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida 33136, USA.
Ellies
P
P
Pires
R T
RT
Tseng
S C
SC
D000328:Adult; D000368:Aged; D000650:Amnion / Q000637:transplantation*; D001485:Basement Membrane; D002675:Child, Preschool; D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery*; D019573:Epithelium, Corneal; D005260:Female; D006801:Humans; D016850:Limbus Corneae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D020795:Photophobia / Q000601:surgery; D013234:Stem Cells / Q000473:pathology*; D016042:Transplantation, Heterotopic / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity