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K. Boboridis, N. Ziakas, N. Georgiadis; Early Treatment of Moderate and Severe Anterior Segment Alkali Burns with Amniotic Membrane and Limbal Stem Cell Graft Placement . Invest. Ophthalmol. Vis. Sci. 2003;44(13):689.
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Purpose: Alkali chemical burns disrupt the normal anterior segment barriers, increase the anterior chamber pH and damage the lens and anterior uvea, causing structural damages, secondary glaucoma and in severe cases phthisis bulbi. Several medical and surgical treatment modalities have been proposed for their management. We present our experience with the use of preserved amniotic membrane and stem cell graft in the early acute phase of severe alkali burns Methods: A prospective non comparative interventional study included 14 patients, 6 of which suffered a stage II burn, 5 a stage III burn and the remaining 3 IV burn. Amniotic membrane was applied on the corneal surface and secured with sutures through 360 degrees conjunctival peritomy within the first week and also limbal stem cell graft was placed in three patients. Topical steroid, sodium citrate, vitamin C, acetylcystein and artificial tear drops were administered from the day of admission. Results: All patients recovered well and the opaque corneas of stage III and IV burns cleared within 4 weeks with no epithelial defects and conjunctivalization of the cornea. Medical treatment continued for at least 6 months after full recovery was noted. Conclusions: Early amniotic membrane application and limbal stem cell graft can improve the recovery of severe anterior segment chemical burns by promoting corneal epithelization and minimizing the inflammatory sequel.
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