97th DOG Annual Meeting 1999

K566

TRANSPLANTATION OF PRESERVED HUMAN AMNIOTIC MEMBRANE FOR RECONSTRUCTION OF OCULAR SURFACES, CASE REPORTS

F. Sistani , G. Schwartze, U. Hartmann, T. Damms, U. H. Steinhorst, R. Winter.


Introduction: Recently, transplantation of human amniotic membranes has been introduced to reconstruct ocular surfaces. It can be used to cover the denuded area of the sclera after excision of a pterygium or to cover persisting lesions of the cornea such as epithelial defects or sterile corneal ulcers. We report about our clinical experience with this technique.

Materials and Methods: Amniotic membranes were harvested from donors after cesarean sections. Serological tests were carried out to exclude viral infections and syphilis. The placenta was washed thoroughly to remove blood. The Amnion was separated from underlying chorion and spread on nitrocellulose paper with the epithelial surface facing upwards. Amnion together with the nitrocellulose paper was cut in different sizes ranging from 1cmx1cm to 3cmx3cm. These pieces were brought into cryopreservation vials. The vials were transferred to fluid nitrogen (-196ºC) and stored until use. Between 4/98-11/98 we performed amnionplasties in 17 patiens. In nine cases an amnionplasty was performed to cover the sclera after excision of a pterygium. In eight cases it was carried out to cover persistant corneal defects, either by corneal ulcers or by therapy-resistant epithelial defects.

Results: A complete reepithelialization could be observer in 15 cases after 10 days. In 2 cases a penetrating keratoplasty had to be performed due to lack of reepithelialization. First signs of a recurrence of a pterygium could be observed after 5 months in 5 cases.

Conclusions: The use of amnion tissue to reconstruct ocular surfaces is a suitable technique to reconstruct ocular surfaces permanantly or to gain time for a planned penetrating keratoplasty.

Dept. of Ophthalmology, Hannover Medical School, Carl-Neuberg Str.1, Hannover, Germany.


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