title: Clinical outcomes of amniotic membrane transplantation in the management of acute ocular chemical injury.
abstract: Amniotic membrane transplantation (AMT) has been used in the management of acute ocular chemical burns to promote epithelialisation, reduce inflammation and restore ocular surface integrity. The aim of this study is to analyse the morphological and functional outcomes of patients receiving AMT after ocular chemical burn.
  
  
  
  We performed a retrospective analysis of all patients treated for acute ocular chemical burn between 1998 and 2008 in two participating centres (University of Duisburg-Essen, Germany and Royal Victoria Infirmary, Department of Ophthalmology, Newcastle University, UK). Ocular chemical burns were classified by Roper-Hall and Dua classifications.
  
  
  
  72 eyes of 54 consecutive patients aged 37.3 years (±SD 11.6 years) were included in this cohort study. 7 chemical burns were acid burns, 61 were alkaline and 4 were of unknown origin. In 37 eyes (51.4%), AMT was applied within the first 6 days after injury. Mean follow-up time was 36.4 months (median 18.5; 1.3-117.3  months). Overall, 29 eyes (40.3%) achieved a best-corrected visual acuity of LogMAR 0.2 (0.63 decimal) or better at final visit. Complete 360° limbal stem cell deficiency (LSCD) occurred in 33 eyes (45.8%), while partial LSCD occurred in 21 eyes (29.2%).
  
  
  
  AMT is an effective adjunctive treatment in the management of acute ocular chemical burns to support epithelial healing and restore ocular surface integrity with potential to improve vision. However, long-term debilitated vision remained in those with severe burns complicated by LSCD.
authors.affiliation: Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany.
authors.forename: Henrike
authors.initials: H
authors.lastname: Westekemper
authors.affiliation: Department of Ophthalmology, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Francisco C
authors.initials: FC
authors.lastname: Figueiredo
authors.affiliation: Department of Ophthalmology, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: We Fong
authors.initials: WF
authors.lastname: Siah
authors.affiliation: Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Wagner
authors.affiliation: Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany.
authors.forename: Klaus-Peter
authors.initials: KP
authors.lastname: Steuhl
authors.affiliation: Department of Ophthalmology, University of Jena, Jena, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Meller
mesh_terms: D000293:Adolescent; D000328:Adult; D000650:Amnion / Q000637:transplantation*; D002057:Burns, Chemical / Q000601:surgery*; D002648:Child; D065306:Corneal Injuries / Q000209:etiology / Q000601:surgery*; D019573:Epithelium, Corneal / Q000601:surgery; D005126:Eye Burns / Q000601:surgery*; D005260:Female; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D014792:Visual Acuity; D055815:Young Adult
keywords: Cornea; Inflammation; Ocular surface; Stem Cells; Treatment Surgery