Multilayered amniotic membrane transplantation for severe ulceration of the cornea and sclera

PURPOSE: To examine the efficacy of amniotic membrane transplantation in th e treatment of deep corneal and scleral ulcers, PATIENTS: A total of 11 patients were recruited for this study: four patien ts (four eyes) with corneal perforation, five patients (five eyes) with a d eep corneal ulcer and descemetocele, and two patients (two eyes) with a scl eral ulcer. METHODS: Ulcers were treated by amniotic membrane transplantation. Separate amniotic membranes were transplanted as material to fill the stromal layer (amniotic membrane filling), as a basement membrane (amniotic membrane gra ft), and as a wound cover (amniotic membrane patch). After surgery, all cas es were treated with artificial tears, autologous serum drops, antibiotic e yedrops, topical corticosteroids, and sodium hyaluronate eyedrops, RESULTS: Eight eyes (72.7%) healed with epithelialization in 16.5 +/- 8.0 d ays (range, 7 to 29 days), with five and three eyes showing corneal epithel ialization and conjunctival epithelialization, respectively, A persistent e pithelial defect was noted in one eye with corneal ulcer after limbal allog raft transplantation for a chemical burn and in two eyes with corneal ulcer s as a complication of rheumatoid arthritis. CONCLUSION: Multilayered amniotic membrane transplantation may be effective for the treatment of deep ulceration of the cornea and sclera, In some eye s with total corneal limbal dysfunction or autoimmune disorders, amniotic m embrane transplantation alone is not effective, (Am J Ophthalmol 2001;131:3 24-331, (C) 2001 by Elsevier Science Inc, All rights reserved.).