AMNIOTIC MEMBRANE TRANSPLANTATION FOR CONJUNCTIVAL SURFACE RECONSTRUCTION

PURPOSE: To determine whether preserved hu man amniotic membrane can b e used to reconstruct the conjunctival defect created during surgical removal of a large lesion or during symblepharon lysis. METHODS: Amnio tic membrane transplantation was performed in six consecutive patients (seven eyes) during removal of large conjunctival lesions and in nine patients (nine eyes) during removal of conjunctival scars or symbleph aron. RESULTS: During a mean follow up period +/- SD of 10.9 +/- 9.1 m onths (range, 2.2 to 34.0 months), 10 patients (11 eyes) showed succes sful surface reconstruction without recurrence, five patients (five ey es) showed improved visual acuity, and one patient (one eye) showed ep ithelialization within 3 weeks and resolution of motility restriction. Two patients (two eyes) showed partial success, with surrounding conj unctival inflammation. Three cases (three eyes) failed and exhibited r ecurrent scarring: one patient had received mitomycin treatment and be ta radiation, whereas the transplanted amniotic membrane of the second patient was partially, and of the third patient was completely, disso lved or replaced by the inflamed pseudopterygial tissue. Two patients (two eyes) had epithelial cyst formation. CONCLUSION: Amniotic membran e transplantation can be considered an alternative substrate for conju nctival surface reconstruction during removal for large tumors, disfig uring scars, or symblepharon, especially for those whose surrounding c onjunctival tissue remains relatively normal.