Anwendung mehrschichtig aufgenähter Amnionmembranen in der Erstbehandlung penetrierender Hornhautulzera

Abstract

A corneal penetration secondary to inflammation or chronic trophic disease is an emergency situation in ophthalmology. The ocular globe is instable and there is a significant risk of an endophthalmitis. A corneal graft for a tectonic transplantation may not be available in many cases. The prognosis of an emergency corneal transplantation is relatively poor. We report the results of multilayer amniotic membrane transplantation as initial therapy for penetrating corneal ulcers. In 13 eyes with penetrating corneal ulcers an initial therapy with multilayer amniotic membrane was performed. All patients (11 men, 2 women; age 52-90 years; mean 71.7 years) were given therapeutic contact lenses as well as systemic and local antibiotics. We investigated the postoperative course with regard to stabilisation of the cornea and deepening of the anterior chamber. The anterior chamber was reestablished in 8 of 13 patients (62%) after an average of 5.25 days (range, 1-15) using multi-layer amniotic membrane transplantation. Our data show that an initial treatment of penetrating corneal ulcers with multilayer amniotic membrane is reasonable. With this procedure the surgeon gains sufficient time for obtain a corneal graft for a possible penetrating corneal transplantation.