Amniotic Membrane Extract for Acute Ocular Chemical Burns

Abstract

Background: Ocular chemical burns induce devastating and permanent damage to the ocular surface. Rapid intervention is required for maximal visual rehabilitation. Amniotic membrane transplantation (AMT) may save the ocular surface, however it introduces a potentially unnecessary surgical trauma in such compromised eyes. Amniotic membrane extracts (AME) could be a practical substitute of AMT in acute chemical burn. Aim: To evaluate the efficacy of topical AME in the management of acute ocular chemical burn. Methods: Non-comparative interventional case series. Six eyes of 4 consecutive patients with mild to moderate acute chemical burn, exhibiting persistent epithelial defect, inflammation and haze despite extensive conventional therapy were recruited. Topical AME was prepared and added to the conventional treatment within 2 days of the injury. Pain relief, inflammation, haze, and corneal epithelial healing were monitored. Results: Pain was significantly relieved, and inflammation was markedly reduced in all cases. The corneal epithelial defects rapidly healed while visual acuity improved within 11 (range 4-23) days. During an average follow-up period of 6 months (range, 3-8 months), all eyes retained stable surface with improved corneal clarity without neovascularization or symblepharon. Conclusions: Topical application of AME could be an effective adjunct in the treatment of mild to moderate cases of acute chemical burns. It allows non-traumatic and economic early intervention to promote epithelialization, reduce pain, haze and inflammation in acute phase, and prevent cicatricial complications in chronic phase. This result justifies additional large series controlled studies in the future. (Hosam Sheha, Hisham Hashem, Lingyi Liang, Mohamed Ramzy, Ahmed ZaKi. Amniotic Membrane Extract for Acute Ocular Chemical Burns. Journal of American Science 2010;6(11):427-433). (ISSN: 1545-1003).