Surgical treatment of 32 cases of long-term atopic keratoconjunctivitis using the amniotic membrane.

Abstract

PURPOSE:

To evaluate the use of surgical treatment with amniotic membrane for long-term atopic keratoconjunctivitis. Damaged corneas were repaired with various techniques: amniotic membrane transplantations, amniotic membrane coverings, amniotic membrane fillings (AMFs), and amniotic membrane inlay fillings, the latter of which were combined with glycerol-preserved corneal transplants.

METHODS:

This retrospective study was conducted on 37 eyes belonging to 37 patients with atopic keratoconjunctivitis. Thirty-two patients were classified into four groups according to surgical technique. Five patients undergoing medical management served as controls. Surgical outcome was measured by recovery time and long-term visual improvement.

RESULTS:

In all surgical eyes, integrity of ocular tissues was effectively restored and symptoms were reduced at 24.4 ± 13 days post recovery. Mean best-corrected visual acuity improved from 0.6 ± 0.2 to 0.198 ± 0.16 logarithm of the minimum angle of resolution (P<0.001). There were no intraoperative or postoperative complications, with the exception of two recurring cases, both controlled by medication. Recovery time of the control groups lasted 52 ± 16 days. In controls, mean best-corrected visual acuity improved from 0.74 ± 0.15 to 0.54 ± 0.29 logarithm of the minimum angle of resolution (P ≤ 0.05). The vision improvement has significant difference for surgical treatment vs medical. (Mann-Whitney U-test, U = 119, P < 0.05, one tailed).Vision improvements remained stable during a mean follow-up period of 21.7 ± 3.8 months.

CONCLUSION:

Patients suffering from severe chronic atopic keratoconjunctivitis and its complications can benefit from suitable surgical treatments: transplants, covers, fillings, or corneal graft surgeries supplemented with AMFs.

• Authors: J Yang, F-H Yang, C-H Peng, D Erol, S H Tsang, X-R Li
• Journal: Eye (London, England) (Eye (Lond)) Vol. 27 Issue 11 Pg. 1254-62 (Nov 2013) ISSN: 1476-5454 [Electronic] England
• PMID: 23949491 (Publication Type: Case Reports, Journal Article)

Topics

• Adolescent
• Adult
• Amnion (transplantation)
• Case-Control Studies
• Child
• Child, Preschool
• Chronic Disease
• Corneal Transplantation (methods)
• Female
• Humans
• Keratoconjunctivitis (surgery)
• Male
• Middle Aged
• Ophthalmologic Surgical Procedures
• Retrospective Studies
• Visual Acuity
• Young Adult