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Amniotic membrane transplantation as an adjunct to medical therapy in acute ocular burns
  1. Radhika Tandon1,
  2. Noopur Gupta1,
  3. Mani Kalaivani2,
  4. Namrata Sharma1,
  5. Jeewan S Titiyal1,
  6. Rasik B Vajpayee1,3
  1. 1Cornea & Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
  3. 3Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
  1. Correspondence to Dr Radhika Tandon, Cornea & Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; radhika_tan{at}yahoo.com

Abstract

Aims To evaluate the role of amniotic membrane transplantation in patients with acute ocular burns.

Methods In a prospective, randomised, controlled clinical trial, 100 patients with grade II to IV acute ocular burns (Roper Hall Classification) were recruited. 50 patients with grade II–III burns were graded as moderate burns, and 50 patients with grade IV burns were graded as severe burns. Both groups were individually randomised into control group (n=25) and study group (n=25). The corresponding grade of ocular surface burn by Dua classification was noted. The eyes in the study group underwent amniotic membrane transplantation in addition to conventional medical therapy. In the control group, conventional medical therapy along with mechanical release of early adhesions as and when necessary was instituted. Rate of healing of corneal epithelial defect, visual acuity, extent of corneal vascularisation, corneal clarity and formation of symblepharon were compared in both groups.

Results In patients with moderate ocular burns treated with amniotic membrane transplantation, the rate of epithelial healing was significantly better than the group treated with standard medical therapy alone (p=0.0004). There was no overall difference in the final visual outcome, symblepharon formation, corneal clarity and vascularisation with or without amniotic membrane transplantation.

Conclusions Amniotic membrane transplantation in eyes with acute ocular burns promotes faster healing of epithelial defect in patients with moderate grade burns. There seems to be no definite long-term advantage of amniotic membrane transplantation over medical therapy and mechanical release of adhesions in terms of final visual outcome, appearance of symblepharon and corneal vascularisation when compared in a controlled clinical setting.

  • Ocular surface
  • conjunctiva
  • cornea
  • vision

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Footnotes

  • Funding Indian Council of Medical Research, Ansari Nagar, New Delhi under Grant-in-aid of Research Scheme (No I-389).The sponsor or funding organisation had no role in the design or conduct of this research.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Ethics Committee of the All India Institute of Medical Sciences (AIIMS), New Delhi, India.

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

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