[Amniotic membrane transplantation for severe acute cases of chemical ocular burn and Stevens-Johnson syndrome].
OBJECTIVE
To study the therapeutic potential of amniotic membrane transplantation in cases of severe acute chemical ocular burn and Stevens-Johnson syndrome.


METHODS
We retrospectively reviewed the records of eight patients, with a total of ten eyes, submitted to amniotic membrane transplantation for treatment of ocular chemical burns and Stevens-Johnson syndrome in the acute phase between January 1999 and May 2008 in the Ophthalmology Department of UNIFESP. Data relating to sex, age, degree of chemical burns, etiology, affected eye, ophthalmological findings, extension of amniotic membrane, surgeries, additional time between the injury and surgery in days, visual acuity before and after surgery, epithelial defect healing (days), complications and time of follow-up in months were collected.


RESULTS
The average age of patients was 35.7 +/- 23.04 years, with six men and two women. Three patients (four eyes) had Stevens-Johnson syndrome and five patients (six eyes) had chemical ocular burn. The epithelial defect was healed at an average of 27.8 +/- 4.7 days (ranging from 20 and 35 days). All patients presented limbal stem cell deficiency in a median follow-up of 7.8 +/- 2.8 months (ranging from six and twelve months) and four eyes developed symblepharon.


CONCLUSIONS
The results suggest that the amniotic membrane transplantation represents an additive that can be carried out in the serious cases of ocular chemical burn and Stevens-Johnson syndrome with the finality of promoting the epithelialization and abolishing the inflammation and its consequences, if compared with other studies that treated similar cases with medical therapy only. On the other hand, it is not possible to avoid the limbic deficiency in these cases, which in the future will need limbal stem cell transplantation or other surgeries for correction of the ocular surface.
Ricardo
José Reinaldo da Silva
JR
Departamento de Oftalmologia, Universidade Federal de São Paulo, SP, Brasil. reinaldoricardo@bol.com.br
Barros
Sabrina Leite de
SL
Santos
Myrna Serapião dos
MS
Souza
Luciene Barbosa de
LB
Gomes
José Alvaro Pereira
JA
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000650:Amnion / Q000637:transplantation*; D002057:Burns, Chemical / Q000601:surgery*; D002648:Child; D005126:Eye Burns / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult