Microsurgicai techniques in amniotic membrane patching for mild to moderate ocular surface burns

Abstract

Objective To evaluate the use of amniotic membrane patches for mild or moderate eye burns at the stage of acute burns and the involved microsurgical techniques.Methods Thirty-four eyes with corneal burns of Ⅱ to Ⅲ degree in which may have partial limbal necrosis were accepted amniotic membrane patching (21 eyes) or pharmaceutical treatment (13 eyes).Four amniotic patches were procured and examined by transmitting electronic microscope when the exposed corneal surface became re-epithelialization after amniotic membrane inching.Results Amniotic patches became partially melting or prolapsed 5-10 (11± 2) days after surgery.The uncovered corneal surface showed quickly re-epithehalized.There were a few thin fibrovascular membrane invaded onto corneal surface in the patients with more than a half limbal necrosis.Postoperative visual acuity increased 1 to 6 (3.3 ± 1.2) lines.The electronic findings showed that most of the infiltrated polymorphonuclear neutrophils in the anmiotic patches became apoptosis.Corneal melting presented in four of 13 eyes who received only drug treatment and lamellar keratoplasty was then performed.The other eyes manifested pseudo-pterygium or symblepharon at different extent.Conclusion Amniotic,patches may reduce the inflammation of burned cornea and corneal neovascularization,accelerate re-epithelialization of corneal surface,even improve the rehabilitation of burned limbal stem cells. Key words: Amniotic membrane patching; Ocular surface reconstruction; Eye burns; Microsurgical technique