title: [Amniotic membrane transplantation for the treatment severe acanthamoeba keratitis].
abstract: BACKGROUND
  It is now possible to treat ocular surface disorders by means of amniotic membrane transplantation. We performed a study to determine the efficacy of this technique in the treatment of severe Acanthamoeba keratitis.
  
  
  METHODS
  We studied six patients with severe, painful, nonhealing Acanthamoeba keratitis who underwent one or two amniotic membrane transplantation procedures between February 2001 and January 2003. Histopathological analysis of the corneal buttons was performed in four cases.
  
  
  RESULTS
  Eight amniotic membrane transplantation procedures were performed. The mean length of follow-up was 14 (range 3-21) months. The mean interval between institution of medical treatment and the procedure was 3.6 months. All patients had progressive stromal lesions caused by an inflammatory reaction. Complete reepithelialization occurred in four cases, and partial healing in two cases. Ocular inflammation and tissue destruction were decreased in all cases, pain was lessened in five cases, and corneal neovascularization was decreased in four cases. No postoperative complications were observed. Amniotic membrane was observed under dysplastic corneal epithelium on histologic examination.
  
  
  CONCLUSIONS
  Amniotic membrane transplantation may be a safe and effective treatment of severe Acanthamoeba keratitis, particularly during the inflammation phase. It may permit penetrating keratoplasty to be delayed.
authors.affiliation: Du Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France. bourcier@quinze-vingts.fr
authors.forename: Tristan
authors.initials: T
authors.lastname: Bourcier
authors.forename: Fabienne
authors.initials: F
authors.lastname: Patteau
authors.forename: Vincent
authors.initials: V
authors.lastname: Borderie
authors.forename: Marie
authors.initials: M
authors.lastname: Baudrimont
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rondeau
authors.forename: Sébastien
authors.initials: S
authors.lastname: Bonnel
authors.forename: Christine
authors.initials: C
authors.lastname: Chaumeil
authors.forename: Laurent
authors.initials: L
authors.lastname: Laroche
mesh_terms: D015823:Acanthamoeba Keratitis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000650:Amnion / Q000637:transplantation*; D001645:Biguanides / Q000627:therapeutic use; D001684:Biological Dressings; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D001645:Biguanides; D005938:Glucocorticoids; C031233:polihexanide