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Sutureless amniotic membrane transplantation for the management of inflammatory corneal perforations: a case series.
First Author: A. Meduri ITALY
Co Author(s): G. Oliverio I. Ninotta A. Valastro F. Alessandrello P. Palino P. Aragona
To present the sutureless amniotic membrane transplantation (SAMT) in patients with corneal perforation secondary to ocular surface inflammatory diseases. The technique consists in applying a double layer of amniotic membrane and a therapeutic contact lens on the corneal surface of the patient.
Ophthalmology Clinic, Department of Biomedical Sciences, University Hospital of Messina, Italy.
Three eyes of 3 patients with corneal perforation (secondary to Sj�gren�s syndrome in two cases, and ocular cicatricial pemphigoid in one patient) were included. BCVA, slit-lamp examination, fluorescein corneal staining, and AS-OCT were evaluated preoperatively and after treatment. The surgical procedure contemplates the application of two layers of the amniotic membrane: the first layer of the same size as the corneal ulcer, and the second one covering the whole corneal surface. A therapeutic contact lens with a diameter of 12mm is placed above these 2 layers. Finally, a sutureless tarsorrhaphy is performed by using steri-strip for a 15-days application period.
After the application period of the SAMT, the three patients presented a complete resolution of the corneal perforation. The pachymetry of the thinnest corneal point and BCVA improved in all patients. Complete epithelization of the corneal ulcer was achieved after the treatment and sustained up to 3 months of follow-up.
The sutureless transplantation of amniotic membrane is a safe and effective option to manage inflammatory corneal perforation; the outcome was satisfactory in all the 3 patients treated, with a complete resolution of the corneal perforation. Furthermore, as the procedure does not involve the use of sutures or fibrin glue, is completely atraumatic, and easy to be performed.
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