Amniotic membrane implantation as a therapeutic contact lens for the treatment of epithelial disorders.
OBJECTIVE
To evaluate the efficacy and safety of amniotic membrane implantation as a therapeutic contact lens in the treatment of different epithelial defects without stromal ulceration.


METHODS
We used amniotic membrane implantation as a therapeutic contact lens in 20 consecutive patients with epithelial defects. Group 1 included 10 patients with persistent epithelial defects that did not respond to medical treatment. Group 2 included 10 patients with surgically induced epithelial defects.


RESULTS
No intra- or postoperative complications were observed. The amniotic membrane implant remained in place for a mean of 12.5 days (range, 3-34). In 11 of the 20 patients, the amniotic membrane implant became detached within the first 8 days. When the corneal implant was postoperatively covered with a soft contact lens, this time increased. In group 1, complete epithelialization was achieved in three of the four cases in which the amniotic membrane remained in place for 2 or more weeks. There were no cases of complete epithelialization in which the implant remained in place for less than 1 week. In group 2, epithelialization was achieved in all cases, regardless of the time that the implant remained in place.


CONCLUSIONS
Amniotic membrane implanted as a therapeutic contact lens can be an effective and safe option for the treatment of different epithelial defects. In patients with persistent epithelial defects, the number of cases with complete postoperative epithelialization was higher when the amniotic membrane remained in place longer. The early detachment of the amniotic membrane implant remains a major problem, even with the use of multiple fixation sutures.
Gris
Oscar
O
Department of Ophthalmology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
del Campo
Zoraida
Z
Wolley-Dod
Charlotte
C
Güell
José L
JL
Bruix
Anna
A
Calatayud
Marta
M
Adán
Alfredo
A
D000328:Adult; D000368:Aged; D000650:Amnion / Q000637:transplantation*; D001684:Biological Dressings; D003263:Contact Lenses, Hydrophilic; D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery*; D004847:Epithelial Cells / Q000473:pathology; D019573:Epithelium, Corneal / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012038:Regeneration; D012449:Safety; D013536:Suture Techniques; D016896:Treatment Outcome