Evaluation of the outcome of amniotic membrane transplantation for ocular surface reconstruction in symblepharon.
OBJECTIVE
Symblepharon is a condition that can inflict serious morbidity on the affected patients. Our aim was to evaluate the efficacy of amniotic membrane transplantation in the surgical treatment of symblepharon by determining the rate of epithelization of the graft, the incidence of complications, and the rate of recurrence of cicatrization.


METHODS
In all, 20 eyes of 18 patients with symblepharon due to various causes and with varied indications for surgery underwent symblepharon excision and amniotic membrane transplantation (AMT).


RESULTS
We observed recurrence of symblepharon in eight out of the 20 eyes operated upon, but in two of these the cicatrization was focal in nature and did not afford any functional impairment to the patients. Four out of the six eyes that failed had preoperative severe dry eye, and four had undergone previous conjunctival surgery.


CONCLUSIONS
AMT appears to be a safe and effective procedure for the surgical treatment of symblepharon. We observed a 100% rate of epithelization of the graft with no significant postoperative complications and a 30% rate of cicatrization. Pre-existing dry eye and previous conjunctival surgery influence the success of the surgery and these eyes may need medical or surgical supplementation along with AMT to limit the amount of subconjunctival fibrosis for better surgical results.
Jain
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S
Guru Nanak Eye Centre, Maharaja Ranjit Singh Marg, New Delhi, India. drsaurabhjain@hotmail.com
Rastogi
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A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000650:Amnion / Q000637:transplantation*; D002648:Child; D003229:Conjunctival Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D015352:Dry Eye Syndromes / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D016896:Treatment Outcome