Amniotic Membrane and Fibrin Glue in the Treatment of Deep Corneal Ulcerations

Abstract

Purpose:: To evaluate a new surgical treatment of deep corneal ulceration with 360° Amniotic Membrane (AM) on corneal surface using fibrin glue adhesive properties.

Methods:: We have included 15 patients (8 men and 7 women). The average age was 82 years (range 71-91). All patients suffered from conjunctival congestion, pain and deep aseptic corneal ulceration of different etiology: post HSV keratytis, neuroparalytic keratopathy, corneal graft rejection, corneal decompensation and Sjogren Syndrome. In all patients visual acuity before surgical treatment was countfingers. All patients were treated with AM transplant with the aid of fibrin glue. Topic antibiotic therapy (netilmicin) was used during post surgical follow-up (1 week, 1 month, 3 months and 6 months).

Results:: AM appeared smooth one week after treatment. In all patients at one month follow-up there was no sign of neovascularisation and membrane began to resorb leaving a transparent corneal surface. At six months follow-up patients gained a medium visual acuity of 0.1-0.2 with ulceration resolving and development of stromal tissue.

Conclusions:: In our experience this surgical treatment is less invasive and increases the patient’s postoperative comfort. The AM implant with fibrin glue is useful in the resolution of ulcerative pathology avoiding a corneal transplantation or a chronic therapy.

Keywords: transplantation • cornea: stroma and keratocytes • clinical (human) or epidemiologic studies: systems/equipment/techniques