Br J Ophthalmol 2001;85:567-575
( May )
Amniotic membrane transplantation for partial limbal stem cell
deficiency
David F Andersona b, Pierre Elliesa b, Renato T F Piresa, Scheffer C G Tsenga b
a Ocular Surface
and Tear Center, Department of Ophthalmology, Bascom Palmer Eye
Institute, Miami, Florida, USA, b Department of Cell Biology and Anatomy,
University of Miami School of Medicine, Miami, Florida, USA
Correspondence to: Scheffer C G Tseng, MD, PhD, Bascom Palmer Eye Institute, William L
McKnight Vision Research Center, 1638 NW 10th Avenue, Miami, FL 33136, USA
stseng{at}bpei.med.miami.edu
Accepted for publication 7 December 2000
AIM
To examine the
efficacy, safety, and long term outcomes of amniotic membrane
transplantation for corneal surface reconstruction in cases of partial
limbal stem cell deficiency.
METHODS17 eyes of 15 patients with partial limbal stem cell deficiency underwent superficial
keratectomy of the conjunctivalised corneal surface followed by
amniotic membrane transplantation. Cases were followed up for at least
a year.
RESULTSAll eyes
exhibited a stable, intact corneal epithelial surface after a mean
follow up period of 25.8 months with no eyes developing recurrent
erosion or persistent epithelial defect. The mean time to
re-epithelialisation was 22.8 days. Overall improvement in visual
acuity was observed in 92.9% of 14 eyes with visual potential. Of
those, five eyes gained six or more lines, two eyes gained between four
and five lines, six eyes gained between one and three lines, and one
eye lost three lines of Snellen acuity. Pain and photophobia were
abolished in 86% of cases and substantially reduced in 14%, with all
eyes exhibiting decreased vascularisation and inflammation at final
follow up.
CONCLUSIONSAmniotic
membrane transplantation appears to be a safe and effective method of
restoring a stable corneal epithelium for cases of partial limbal stem
cell deficiency and can be considered as an alternative to limbal
autograft or allograft.
© 2001 by British Journal of Ophthalmology
