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Amniotic-membrane Transplantation after Chemical Burns

Walter S., Behrens-Baumann W.,
Otto-von-Guericke-Universität Magdeburg, Universitäts-Augenklinik (Magdeburg)

Background: Heavy chemical burns are characterized by corneal epithelium defects and inflammatory responses at the anterior section of the eye. Sorsby and Symons described in 1946 for the first time, the application of amniotic membranes after heavy chemical burns. In 1995 these attempts were further advanced under cell-biological aspects by Tseng and colleagues to achieve a further reduction of the inflammatory responses as well as the stabilization of the corneal epithelium.
Patient: A 38 years old female patient was admitted to the emergency unit of our hospital with a hydrochloric acid burn of the face, including both eyes. In addition to the ocular damage, severe burns of the respiratory tract requested artificial respiration. Biomicroscopy revealed a severe eyelid swelling, conjunctival chemoisis as well as severe corneal epithelial defects and corneal cloudiness on both eyes (OS>OD). Visual acuity was at admission at OD 0,3 and OS 0,1. Within the first 3 days under anti-inflammable therapy, no improvement of the symptoms were detected. An amniotic membrane - and a therapeutic contact lens for stabilization - were therefore applied to the left eye. The amniotic membrane dissolved after 12 days. During this time the cornea epithelium had stabilized. The patient was dismissed with intact cornea epithelium and visual acuity of 0,8 on both eyes.
Conclusion: Application of amniotic membranes as a basal membrane facilitates epithelialization after ocular chemical burns.