Role of amniotic membrane graft for ocular chemical and thermal injuries.
OBJECTIVE
To evaluate the results of amniotic membrane transplantation (AMT) for ocular surface reconstruction in chemical and thermal injuries.


METHODS
Retrospective review of case records of patients who had undergone AMT for chemical injuries (January 1998 to May 2001).


RESULTS
Seventy two eyes of 69 patients were studied of which 24 were acute cases (median-2 days, range, 1-20 days) and 48 were chronic cases (median-12.4 months, range, 1.02-95.8 months). Mean age was 22.4 years (SD +/- 13.34 years) and average follow up duration was 7.8 months (SD +/- 7.1). Main clinical findings were symblephara (52.8%), corneal vascularization (51.3%), conjunctivalization (45.8%), Limbal ischemia (45.8%), Limbal stem cell deficiency (55.5%) and epithelial defect (48.6%). 18 cases were due to acid injuries (5 acute, 13 chronic), 52 were due to alkali (18 acute and 34 chronic) and 2 cases were due to thermal burns (1 each acute and chronic). Overall success rate was 87.5% in acute cases and 72.9% in chronic cases. Indication-wise success rates were 94.3% for epithelial defect healing, 88.2% for symptomatic relief, 59.7% for ocular surface reconstruction, and 55% for improving limbal stem cell function. Success was not achieved in any outcome measure in 1/24 (4.2%) in acute group and 6/48 (12.5%) in chronic group.


CONCLUSIONS
AMT helps in ocular surface reconstruction, promotes rapid epithelial healing and partially restores limbal stem cell function. It can be considered as an effective modality for the ocular surface restoration in chemical and thermal injuries in selected cases. Success rates in acute and chronic cases are comparable.
Tejwani
Sushma
S
Comprehensive Ophthalmology Services, L. V. Prasad Eye Institute, L. V. Prasad Marg, Banjara Hills, Hyderabad. sushma@lvpei.org
Kolari
Rohini S
RS
Sangwan
Virender S
VS
Rao
Gullapalli N
GN
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000650:Amnion / Q000637:transplantation*; D002057:Burns, Chemical / Q000601:surgery*; D017690:Cell Transplantation; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003316:Corneal Diseases / Q000601:surgery*; D004847:Epithelial Cells / Q000637:transplantation; D019573:Epithelium, Corneal / Q000502:physiology; D005126:Eye Burns / Q000139:chemically induced* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000502:physiology; D014945:Wound Healing