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Amniotic membrane (AM) transplantation has been used successfully for the treatment of ocular surface diseases for several years.1–3 Indications for use of AM at the cornea include persistent epithelial defects, corneal ulcers and chemical burns.1–3 Surgical strategies for AM placement onto the cornea are suturing AM onto the corneal surface (“patch”), into a corneal defect (“graft”) or a combination of both strategies (“sandwich”).1–5
All published reports for use of AM in patients are based on the use of sutures. Although most patients can be treated with the suture-based approach, there are several situations in which sutures should be avoided: patients under intensive care, long-lasting corneal epithelial defects causing a cornea too thin to support sutures or sutures may be technically difficult to place in the case of a previous graft, and, in addition, sutures can induce scarring and neovascularisation.6 Since the beneficial effects of AM are at least partially mediated by agents released from AM and by AM acting as a natural bandage contact lens,1–5 we reasoned …
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