Application of amniotic membrane transplantation in severe corneal diseases

PURPOSE: To present our experience with the amniotic membrane transplantation in severe corneal diseases. MATERIAL AND METHODS: In 1998 amniotic membrane transplantation was applied in 18 eyes (17 patients) with severe and persistent corneal diseases. The indications were as follows: perforated corneal ulcer--9 eyes, persistent non-perforated corneal ulcer--4 cases, recurrent transplant disease--2 eyes, 1 patient with Sjogren syndrome and 1 with keratolysis in the course of ulcerative colitis. Amniotic membrane was prepared in the International Eye Bank of Lublin from human placenta after elective caesarean section according to the standard protocol. RESULTS: In 7 eyes with perforated ulcers and 4 eyes with non-perforated ulcers prompt healing was observed. In 4 cases markedly improved visual acuity resulted from corneal clarification. In 1 eye perforation persisted in spite of amniotic membrane transplantation and keratoplasty was performed afterwards. In the case of keratolysis, amniotic membrane transplantation did not prevent corneal perforation which was closed successfully with autologous conjunctival flap. In 2 eyes with recurrent transplant disease amniotic membrane dissolved quickly after transplantation. In one case the state of the cornea improved. The second eye required retransplantation of the membrane. We observed that amniotic membrane dissolved more quickly in a vascularized bed. CONCLUSION: Amniotic membrane transplantation may be considered a good alternative method for treating severe corneal disorders that are refractory to conventional treatment.