Long-Term Follow-Up of Multilayer Amniotic Membrane Transplantation (MLAMT) for Non-Traumatic Corneal Perforations or Deep Ulcers with Descemetocele.
2013
Background: To evaluate the long-term efficacy of multilayer amniotic
membrane transplantation for reconstruction of epithelium and stroma in
non-traumatic corneal perforations (less than 2 mm) or deep ulcers with
descemetocele. Design: Retrospective, non-comparative, interventional case
series. Patients and Methods: Eleven consecutive patients with non-traumatic
corneal perforations or deep corneal ulcers with descemetocele refractory to
conventional treatments: herpetic or zoster keratitis (n = 4), Sjogrenʼs
syndrome (n = 2), rosacea (n = 1), hydrops (n = 1), mucous membrane
pemphigoid (n = 1), bacterial keratitis (n = 1) and perforation after
protontherapy for melanoma (n = 1). Intervention was: multilayer amniotic
membrane transplantation with cryopreserved amniotic membrane. Complication
rate and clinical outcome were evaluated in this long-term follow-up. Results: Mean follow-up was 32 months (12 to 60). Integration of the
multilayer amniotic membrane was obtained in 10 cases after one year.
Corneal epithelium healed above the membrane in 10 cases within 3 weeks and
remained stable after 32 months in 9 cases. Thickness of the stroma was
increased and remained stable during the follow-up in 9 cases. In one case
herpetic keratitis recurred with a corneal perforation. The clearing of the
amniotic membrane was gradually obtained over a period of 11 months.
Complications occurred in 15 % of the eyes during the long-term
follow-up. Conclusion: Multilayer amniotic membrane transplantation is a safe and
efficient technique for a long restoration of the corneal integrity after
non-traumatic corneal perforations or deep corneal ulcers with
descemetocele. Long-term prognosis of these eyes depends of the gravity of
the initial disease.
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