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P.M. Prahs, W. Herrmann, K. Hufendiek, V.–P. Gabel; Amniotic Membrane Transplantation for the Treatment of Rheumatoid Arthritis–Associated Corneal Ulcers . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3950.
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To evaluate the efficacy of amniotic membrane transplantation for the treatment of corneal ulcers in patients with rheumatoid arthritis.
In a retrospective study 9 eyes of 7 consecutive patients with corneal ulcers associated with rheumatoid arthritis were evaluated. In all patients a peripheral corneal ulcer extending 80–90% of stromal thickness resistant to conventional therapy was treated with an amniotic membrane transplantation. The corneal defects were filled with an amniotic membrane graft and an amniotic membrane patch was applied over the whole cornea (sandwich technique). Additionally all patients continued conservative treatment including systemic steroids. Clinical success was defined as healing of the ulcer 3 months after surgery.
Epithelial closure over the implanted graft was achieved in 6 of 9 eyes (66%) after a mean time of 25 days (range 18–31 days, SD ± 6,7) and remained closed over a minimum of 3 months. In one patient the procedure had to be repeated due to the loss of the transplant in the postoperative period. Epithelial closure was observed after the second surgery. In a severe case penetrating keratoplasty was necessary in both eyes due to progression of systemic disease resulting in corneal perforation.
The results of this case series indicate that amniotic membrane transplantation is an effective option for treatment of corneal ulcers in patients with rheumatoid arthritis resistant to conservative therapy.
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