Clinical Observation On Amniotic Membrane Transplantation In Treatment For Ocular Chemical Injury And Thermal Burns

Objective: Eyes surface burn is a common ocular disease，which is easy tocause blindness. Amniotic membrane with its special effects has become ahotspot of research in ocular surface reconstruction。In this study，we observedthe therapeutic effect of amniotic membrane transplantation for acutechemical、thermal burns at eyes surface.Method:22patients(22eyes) with acute eyes’ chemical、thermal burnswas selected from Jilin University China-Japan Union Hospital during2009.09-2011.10(Ⅱ degrees5eyes, Ⅲ degrees14eyes and Ⅳ degree3eyes).AMT was performed then. And we observed amniotic membraneadherence, epithelium healing and corneal transparency, vision acuity,postoperative rejection and corneal neovascularization. Patients were followedup6to18months, mean12mouths.Results：The AM grafts were mild edema early after the surgery,3-5dayslater the edema started to relieve, the grafts began to become thinner, partlyautolyzed after one week and we distinguish the AM organization existed bynaked eyes after1month.10eyes’ AM grafts fall off during the1st week afterthe surgery, among them,6eyes’ corneal epithelium still had wide rangecoloboma, so they had the AMT again. Finally, AMT were successes on20eyes out of22patients’22eyes, which means corneal stimulating signs weresignificantly reduced; epithelium healed; the vision acuity was significantimproved compared with preoperative (P <0.05);no rejection was observedduring the follow up period. Among them,4eyes accepted twice AMT therapyto obtain better results. And the surgery failed in2eyes(Ⅳ degree), for itssevere injury, the cornea finally perforated after twice AMT treatments, finally lamellar keratoplasty was performed. Corneal neovascularization was observedin12eyes（Ⅲ degrees9eyes and Ⅳ degree3eyes).5eyes<1quadrant(Ⅲdegrees5eyes),5eyes between1-3quadrants(Ⅲ degrees4eyes and Ⅳdegree1eyes),2eyes>3quadrants(Ⅳ degree2eyes).Conclusion:1.AMT is an effective treatment measure for acute chemical、thermal burns. It had some effect on relieve symptoms, Shorten Disease Course,Optimized prognosis. In the severe injure cases, AMT could Optimized ocularsurface microenvironment for the further treatment.2.AM grafts might meltedor fall off early after the surgery，to obtain a better result, more times AMTcould be considered.3. In the severe cases, only AMT cannot reconstruct thewhole ocular surface. We should use AMT as a first step to reduce inflame-mation, optimized prognosis. Further disposal should be taken to accom-plishocular surface reconstruction.