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S. Barabbino, M. Rolando, G. Bentivoglio, C. Mingari, G. Calabria; Treatment of Ocular Surface Inflammation in Keratoconjunctivitis Sicca by Means of Amniotic Membrane . Invest. Ophthalmol. Vis. Sci. 2003;44(13):687.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To evaluate the role of amniotic membrane (AM) patch in the amelioration of symptoms and signs of inflammation of the ocular surface in patients with keratoconjunctivitis sicca (KCS). Methods:Twenty-four eyes of 12 patients (9 female, average age 59.2±8.6 yrs) with bilateral KCS were randomly divided into two groups. The study group (n=12) underwent to cryopreserved AM application epithelium-down on all the exposed ocular surface with a high dK contact lens (CL), while the control group (n=12) wore the same type of CL for 48 hours. Symptoms were studied by means of a validated questionnaire. The ocular surface conditions were evaluated by conjunctival hyperaemia (grade 0-4), lissamine green staining (grade 0-9), corneal sensitivity (Cochet-Bonnet test) and by the expression of HLA DR, a Major Hystocompatibility Class II antigen, tested on epithelial bulbar conjunctiva samples. All the patients underwent to preservative free tear substitutes 6 times daily during the study. All the studied parameters were recorded at 7 (D7) and 28 (D28) days from baseline (D0). Results:No statistical differences in symptoms, signs or ocular surface inflammation between groups were recorded at D0. Statistically significant changes in the study group as compared with the control group were found in symptoms (p<0.05 at D7, p<0.005 at D28), conjunctival hyperaemia (p<0.005 at D7, p<0.05 at D28), lissamine green staining (p<0.05 at D7, n.s. at D28) and HLA DR expression (p<0.05 at D7, p<0.005 at D28). No statistically significant difference between the groups was recorded for corneal sensitivity. Conclusions:Amniotic membrane patch, additionally to tear substitutes, is able to reduce ocular surface inflammation and to improve symptoms in dry eye patients. Long-term studies are, however, needed to confirm the role of this new therapy for keratoconjunctivitis sicca.
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