Abstract

SA.20.02

Long-term results after amniotic membrane transplantation in the acute phase of chemical burns

Emre Türkeli1, Henrike Westekemper1, Nina Niederdräing1, Thomas Fuchsluger1, Klaus-Peter Steuhl1, Francisco Fiqueiredo2, Daniel Meller1
1Zentrum für Augenheilkunde, Universitätsklinikum Essen, Essen; 2Royal Victoria Infirmary, Newcastle upon Tyne, UK

Purpose
Amniotic membrane transplantation (AMT) has been used in the management of acute ocular burns. Retrospectively, we analysed the morphological and functional outcome of patients that received AMT after chemical burn.
Methods
Eighty-six eyes of 62 patients aged 37.6 ± 11.5 years were included in the study. Eleven chemical burns were acid-burns, all others were of alkaline origin, 24 patients had bilateral burns and 17 received bilateral amniotic membrane (AM). In 49 eyes (57.0%) AM was applied within the first 6 days after injury. We have analysed the functional and anatomical outcome after chemical burn retrospectively and correlated it to the degree of injury and the acute treatment.
Results
Mean follow-up time was 31.4 (min. 0.1, max. 117.3, median 17.5) months. Following the Dua-classification for ocular surface burns, 29 eyes (33.7%) showed grade I-III, 12 (14.0%) showed grade IV and 45 eyes (52.3%) were classified as grade V-VI. Twenty-eight eyes (32.5%) required re-operation with another AMT due to persistent epithelial defect. In total 35 eyes (40.7%) reached final visual acuity of 0.63 (decimal; LogMAR:0.2) or better. Complete 360° LSCD occurred in 33 eyes (38.4%), partial LSCD occurred in 24 eyes (28%).
Conclusions
AMT is an effective tool in the treatment of acute chemical burns to restore ocular surface integrity. Prognosis worsens rapidly with increasing severity of the injury. In grade V and VI burns it cannot prevent LSCD.

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