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Clinical outcomes of amniotic membrane transplantation in the management of acute ocular chemical injury
  1. Henrike Westekemper1,
  2. Francisco C Figueiredo2,
  3. We Fong Siah2,
  4. Nina Wagner1,
  5. Klaus-Peter Steuhl1,
  6. Daniel Meller3
  1. 1Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany
  2. 2Department of Ophthalmology, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK
  3. 3Department of Ophthalmology, University of Jena, Jena, Germany
  1. Correspondence to Professor Daniel Meller, Department of Ophthalmology, University of Jena, Bachstraße 18, Jena D-07740, Germany; daniel.meller{at}med.uni-jena.de

Abstract

Background Amniotic membrane transplantation (AMT) has been used in the management of acute ocular chemical burns to promote epithelialisation, reduce inflammation and restore ocular surface integrity. The aim of this study is to analyse the morphological and functional outcomes of patients receiving AMT after ocular chemical burn.

Methods We performed a retrospective analysis of all patients treated for acute ocular chemical burn between 1998 and 2008 in two participating centres (University of Duisburg-Essen, Germany and Royal Victoria Infirmary, Department of Ophthalmology, Newcastle University, UK). Ocular chemical burns were classified by Roper-Hall and Dua classifications.

Results 72 eyes of 54 consecutive patients aged 37.3 years (±SD 11.6 years) were included in this cohort study. 7 chemical burns were acid burns, 61 were alkaline and 4 were of unknown origin. In 37 eyes (51.4%), AMT was applied within the first 6 days after injury. Mean follow-up time was 36.4 months (median 18.5; 1.3–117.3  months). Overall, 29 eyes (40.3%) achieved a best-corrected visual acuity of LogMAR 0.2 (0.63 decimal) or better at final visit. Complete 360° limbal stem cell deficiency (LSCD) occurred in 33 eyes (45.8%), while partial LSCD occurred in 21 eyes (29.2%).

Conclusion AMT is an effective adjunctive treatment in the management of acute ocular chemical burns to support epithelial healing and restore ocular surface integrity with potential to improve vision. However, long-term debilitated vision remained in those with severe burns complicated by LSCD.

  • Cornea
  • Inflammation
  • Ocular surface
  • Stem Cells
  • Treatment Surgery

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Footnotes

  • HW and FCF should both be considered first authors.

  • Contributors All authors contributed to the conception and design of the work, were involved in the acquisition of data, reviewed and revised the manuscript and gave final approval of the version to be published.

  • Competing interests None declared.

  • Ethics approval This is a retrospective study on patients who had undergone treatment with amniotic transplantation for ocular chemical injury. This study had been approved by the Local Clinical Governance/Research Ethics Committees.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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