Abstract | PURPOSE: To determine if multilayer amniotic membrane transplantation (AMT) is useful in the treatment of corneal perforations, and in particular to assess to what extent efficacy is affected by perforation size. METHODS: Fifteen patients (15 eyes) with corneal perforations of different sizes were divided into 3 groups: group A (microperforation, 6 eyes), group B (0.5-1.5 mm, 4 eyes), and group C (>1.5 mm, 5 eyes). The corneal perforation was caused by autoimmunity-related ulcer (3 eyes), neurotrophic ulcer (9 eyes), infectious keratitis (1 eye), or postkeratoplasty ulcer (2 eyes). Two layers of AM (for microperforations) or 3-4 layers (for the other groups) were trimmed to the size of the ulcer and sutured in place with interrupted 10-0 nylon sutures. In all cases, a bandage contact lens was then applied. RESULTS: Mean epithelialization time was 3.7 weeks (range 2-6). Mean time to recovery of corneal stroma thickness was 10.1 weeks (range 7-15). In all cases, ocular inflammation subsided within 2-5 weeks. The treatment was judged successful in 73% (11/15) of eyes. Three of the 4 unsuccessful treatments were of perforations 3 mm or more in diameter; of the 5 eyes with perforations of more than 1.5 mm in diameter, only 2 were treated successfully. CONCLUSIONS: These results suggest that multilayer AMT is effective for treating corneal perforations with diameter less than 1.5 mm. The technique may be a good alternative to penetrating keratoplasty, especially in acute cases in which graft rejection risk is high.
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Authors | M Teresa Rodríguez-Ares, Rosario Touriño, M Jesús López-Valladares, Francisco Gude |
Journal | Cornea
(Cornea)
Vol. 23
Issue 6
Pg. 577-83
(Aug 2004)
ISSN: 0277-3740 [Print] United States |
PMID | 15256996
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Amnion
(transplantation)
- Biological Dressings
- Cornea
(pathology, surgery)
- Corneal Ulcer
(pathology, surgery)
- Epithelium, Corneal
(pathology)
- Female
- Humans
- Male
- Middle Aged
- Rupture, Spontaneous
- Wound Healing
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