| Past Issue | Volume 8, Number 5, October 2006 | | Preserved Human Amniotic Membrane Transplantation in Patients with Trachoma: a Retrospective Analysis |
Radha Shenoy,1 Alexander Bialsiewicz,1 Abdullah Al-Muniri,2 Archana Thakral1
1Department of Ophthalmology and School of Ophthalmic Technicians, and 2Department of Epidemiology and Medical Statistics, Sultan Qaboos University College of Medicine and Health Sciences, Muscat, Oman
Aim: To evaluate the outcomes of human amniotic membrane transplantation for rehabilitation of ocular surface disorders, with special reference to cicatrising trachoma.
Patients and Methods: Cryopreserved human amnion from healthy donors was grafted in 19 eyes of 14 patients with cicatrising trachoma, 4 eyes of 2 patients with Stevens-Johnson syndrome, and 2 eyes of 1 patient with chemical burns. Follow-up was performed 1 week, 6 weeks, and 6 months after surgery. Outcomes evaluated were re-epithelialisation of the corneal surface, visual acuity, recurrence of symblepharon, and corneal vascularisation. The results for patients with trachoma were compared with those for patients with Stevens-Johnson syndrome and chemical burns.
Results: Twenty five eyes of 17 patients underwent human amniotic membrane transplantation. The success rate for eyes with trachoma did not differ from those without trachoma. After 6 months, 15 of 19 eyes with trachoma (79%) had developed recurrence of symblepharon compared with 2 of 6 eyes without trachoma (33.3%) [p = 0.06] and 13 of 15 eyes (86.6%) with cicatricial trachoma experienced a recurrence of corneal vascularisation compared with 2 of 6 eyes without trachoma (p = 0.18). Persistent long-term re-epithelialisation was observed in 1 of 19 eyes with trachoma (5.3%) compared with 4 of 6 eyes without trachoma (66.7%) [p = 0.005]. Three of 19 eyes with trachoma perforated under the graft and had to be enucleated.
Conclusion: The outcome for human amniotic membrane grafting in ocular surface reconstruction depends on the extent and severity of the primary disease, and its efficacy was limited for rehabilitation of cicatrising trachoma.
Key words: Amnion, Eye burns, Reconstructive surgical procedures, Stevens-Johnson syndrome, Trachoma, Transplantation
Asian J Ophthalmol 2006;8:191-194.
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