Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations
Purpose. To report on surgical approaches using amniotic membrane applications and patch grafts in corneal melting and perforations. Anatomical and functional results, including advantages and disadvantages of the interventions, will also be explored. Methods. A five-year retrospective analysis of 1...
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| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2020/4238919 |
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| author | Katarzyna Krysik Dariusz Dobrowolski Edward Wylegala Anita Lyssek-Boron |
| author_facet | Katarzyna Krysik Dariusz Dobrowolski Edward Wylegala Anita Lyssek-Boron |
| author_sort | Katarzyna Krysik |
| collection | DOAJ |
| description | Purpose. To report on surgical approaches using amniotic membrane applications and patch grafts in corneal melting and perforations. Anatomical and functional results, including advantages and disadvantages of the interventions, will also be explored. Methods. A five-year retrospective analysis of 189 surgical treatments involving corneal melting with perforation was performed. In one evaluated treatment type, a graft of amniotic membrane, often folded one to three times, was sutured with the epithelial side facing the previously mechanically debrided corneal tissue. A larger monolayer amniotic patch was then sutured, with the epithelial side facing the top of the first membrane, to the perilimbal conjunctiva. For corneal patch grafts, the size-fitting technique of graft trephination was applied, and the donor-recipient junctions were sewn with interrupted sutures. All the procedures were evaluated, noting outcomes and complications of surgery, preoperative and postoperative visual acuities, postoperative intraocular pressures, graft rejection, and other late comorbidities and complications. Results. We performed 119 amniotic membrane applications (63%) and 70 corneal patch grafts (37%). Anatomical reconstruction of the anterior chamber was achieved in 157 eyes, of which 102 eyes (86%) received an amniotic membrane and 55 eyes (79%) were treated with the patch graft technique. In 63 eyes (33%), more than one amnion or graft treatment was necessary to close the corneal perforation. Conclusions. The success of medical and surgical management depends on the cause of corneal melting, and amniotic membrane applications often require further intervention; nevertheless, patch grafts deliver better tectonic reconstruction than amniotic membrane alone. |
| format | Article |
| id | doaj-art-cd0092603fa44044915f1e022f99f1ee |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-cd0092603fa44044915f1e022f99f1ee2025-02-03T00:58:46ZengWileyJournal of Ophthalmology2090-004X2090-00582020-01-01202010.1155/2020/42389194238919Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and PerforationsKatarzyna Krysik0Dariusz Dobrowolski1Edward Wylegala2Anita Lyssek-Boron3Department of Ophthalmology with Pediatric Unit, St Barbara 5th Regional Hospital, Trauma Centre Medykow Square 1, 41200 Sosnowiec, PolandChair and Clinical Department of Ophthalmology, School of Medicine, Dentistry Division in Zabrze, Medical University of Silesia, Panewnicka 65 Str., 40760 Katowice, PolandChair and Clinical Department of Ophthalmology, School of Medicine, Dentistry Division in Zabrze, Medical University of Silesia, Panewnicka 65 Str., 40760 Katowice, PolandDepartment of Ophthalmology with Pediatric Unit, St Barbara 5th Regional Hospital, Trauma Centre Medykow Square 1, 41200 Sosnowiec, PolandPurpose. To report on surgical approaches using amniotic membrane applications and patch grafts in corneal melting and perforations. Anatomical and functional results, including advantages and disadvantages of the interventions, will also be explored. Methods. A five-year retrospective analysis of 189 surgical treatments involving corneal melting with perforation was performed. In one evaluated treatment type, a graft of amniotic membrane, often folded one to three times, was sutured with the epithelial side facing the previously mechanically debrided corneal tissue. A larger monolayer amniotic patch was then sutured, with the epithelial side facing the top of the first membrane, to the perilimbal conjunctiva. For corneal patch grafts, the size-fitting technique of graft trephination was applied, and the donor-recipient junctions were sewn with interrupted sutures. All the procedures were evaluated, noting outcomes and complications of surgery, preoperative and postoperative visual acuities, postoperative intraocular pressures, graft rejection, and other late comorbidities and complications. Results. We performed 119 amniotic membrane applications (63%) and 70 corneal patch grafts (37%). Anatomical reconstruction of the anterior chamber was achieved in 157 eyes, of which 102 eyes (86%) received an amniotic membrane and 55 eyes (79%) were treated with the patch graft technique. In 63 eyes (33%), more than one amnion or graft treatment was necessary to close the corneal perforation. Conclusions. The success of medical and surgical management depends on the cause of corneal melting, and amniotic membrane applications often require further intervention; nevertheless, patch grafts deliver better tectonic reconstruction than amniotic membrane alone.http://dx.doi.org/10.1155/2020/4238919 |
| spellingShingle | Katarzyna Krysik Dariusz Dobrowolski Edward Wylegala Anita Lyssek-Boron Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations Journal of Ophthalmology |
| title | Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations |
| title_full | Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations |
| title_fullStr | Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations |
| title_full_unstemmed | Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations |
| title_short | Amniotic Membrane as a Main Component in Treatments Supporting Healing and Patch Grafts in Corneal Melting and Perforations |
| title_sort | amniotic membrane as a main component in treatments supporting healing and patch grafts in corneal melting and perforations |
| url | http://dx.doi.org/10.1155/2020/4238919 |
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