Amniotic membrane transplantation in acute chemical burns.
OBJECTIVE
To evaluate the outcome of fresh amniotic membrane transplantation (AMT) for ocular surface reconstruction in acute chemical burns.


METHODS
A prospective study of 15 consecutive eyes with acute chemical burns was performed. In all, 10 eyes had lime burns and five eyes had acid burns. There were three eyes of grade II, four eyes of grade III and eight eyes of grade IV burns. AMT was performed within 3 weeks of injury.


RESULTS
Patients were followed up for 10.14 +/- 4.41 months. All patients had immediate relief of pain postoperatively. Of 15 eyes, nine (60%) showed epithelialization within 1-4 weeks (15.33 +/- 9.91 days). The final visual acuity improved in 10 of 15 eyes (66.66%). Eyes with burns of grade II and III showed more visual improvement than those with grade IV burns. None of the eyes showed perforation. Symblepharon was seen in nine of 15 eyes (60%). Of 15 eyes, 12 (80%) experienced limbal stem cell deficiency and showed superficial corneal vascularization.


CONCLUSIONS
Amniotic membrane transplantation with fresh amniotic membrane increases patient comfort and reduces inflammation. In mild burns, AMT alone restores corneal and conjunctival surfaces. In moderate to severe burns, it probably reduces conjunctival scarring sequelae, but does not prevent the sequelae of limbal stem cell deficiency that requires further limbal stem cell transplantation. In the acute stage, amniotic membrane transplantation probably has a protective role against the progressive melting and perforation.
Cornea Services, Guru Nanak Eye Center, New Delhi 110002, India. aroraj@del3.vsnl.net.in
R
R
Arora
D
D
Mehta
V
V
Jain
D000293:Adolescent; D000328:Adult; D000650:Amnion / Q000637:transplantation*; D002057:Burns, Chemical / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D003228:Conjunctiva / Q000293:injuries; D065306:Corneal Injuries; D005126:Eye Burns / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016850:Limbus Corneae / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014792:Visual Acuity; D014945:Wound Healing