Amniotic membrane transplantation in severe ocular surface disorders

PURPOSE. Amniotic membrane transplantation is currently being used as an alternative approach to treat severe corneal surface disorders refractory to medical therapy. The authors report complications of corneal surface disorders after successful amniotic membrane transplantation. METHODS. Case series. RESULTS. Twenty-eight patients with corneal surface disorders due to severe chemical burns, corneal ulceration, or persistent epithelium defects were treated with amniotic membrane transplantation. Four of these patients showed a spontaneous perforation and three patients developed a descemetocele within 6 weeks after the amniotic membrane transplantation. CONCLUSIONS. In this case series, descemetocele and corneal perforation occurred in 25% of the patients after amniotic membrane transplantation. This might be due to the severity of the underlying disease or to the impact of amniotic membrane on corneal fibroblasts and collagenases. The risk of corneal thinning and perforation should be considered in the decision of treatment with amnion and follow-up regimen. (Eur J Ophthalmol 2008; 18: 691-4)