Ocular surface reconstruction in LOGIC syndrome by amniotic membrane transplantation

Purpose. To determine whether preserved amniotic membrane can be used to re construct the ocular surface after excision of the invading granulation mat erial typical of LOGIC syndrome (laryngeal and ocular granulation tissue in children front the Indian subcontinent). Methods. Granulation tissue was d issected and excised from both eyes of a 10-year-old boy with LOGIC syndrom e. This procedure was followed by coverage of the corneal, scleral, and sub tarsal regions of each eye with amniotic membrane, which had been stored fo r 6 months at -70 degreesC. Results. Initial 2.5-month follow up demonstrat ed complete disappearance of granulation tissue. The fornices were patent, there was no recurrences of symblepharon, ocular inflammation was suppresse d, and the patient reported markedly increased comfort. Both eyelids remain ed ptotic because of levator muscle atrophy secondary to many years of inab ility to open either eye. No residual scarring or evidence of granulation t issue was observed in that period. The 10-month follow up demonstrated limi ted recurrence, particularly where there was an intraoperative break in the amniotic membrane. Conclusions. After 24 operations to treat the ocular co mplications induced by LOGIC syndrome, amniotic membrane transplantation wa s the first effective treatment. In the early follow up period (2-3 months) , there was complete cessation of the proliferation of granulation tissue a nd reepithelialization of the corneal surface. Longer follow up (10 months) demonstrated limited recurrence, which will require retreatment.