Evaluation of the outcome of amniotic membrane transplantation for ocular surface reconstruction in symblepharon

doi:doi:10.1038/sj.eye.6701379

Eye (2004) 18, 1251–1257. doi:10.1038/sj.eye.6701379 Published online 30 April 2004

Evaluation of the outcome of amniotic membrane transplantation for ocular surface reconstruction in symblepharon

We certify that this work has not been submitted or been previously published in any other journal. No grants or sponsorships have been requisitioned for this study. The authors do not have any commercial interest in any product or procedure mentioned in this manuscript.

This work has been presented in part at the XX Congress of the European Society of Cataract and Refractive Surgeons, Nice 7–11 September 2002 and the VI Ophthalmological Conference of SAARC Countries held in Kathmandu, Nepal, November 19–21, 1999.

S Jain¹ and A Rastogi¹

¹Guru Nanak Eye Centre, Maharaja Ranjit Singh Marg, New Delhi, India

Correspondence: S Jain, MS, MRCOphth, Kings College Hospital, Denmark Hill, London SES 9RS. E-mail: drsaurabhjain@hotmail.com

Received 23 May 2003; Accepted 6 November 2003; Published online 30 April 2004.

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Abstract

Aims Symblepharon is a condition that can inflict serious morbidity on the affected patients. Our aim was to evaluate the efficacy of amniotic membrane transplantation in the surgical treatment of symblepharon by determining the rate of epithelization of the graft, the incidence of complications, and the rate of recurrence of cicatrization.

Methods In all, 20 eyes of 18 patients with symblepharon due to various causes and with varied indications for surgery underwent symblepharon excision and amniotic membrane transplantation (AMT).

Results We observed recurrence of symblepharon in eight out of the 20 eyes operated upon, but in two of these the cicatrization was focal in nature and did not afford any functional impairment to the patients. Four out of the six eyes that failed had preoperative severe dry eye, and four had undergone previous conjunctival surgery.

Conclusions AMT appears to be a safe and effective procedure for the surgical treatment of symblepharon. We observed a 100% rate of epithelization of the graft with no significant postoperative complications and a 30% rate of cicatrization. Pre-existing dry eye and previous conjunctival surgery influence the success of the surgery and these eyes may need medical or surgical supplementation along with AMT to limit the amount of subconjunctival fibrosis for better surgical results.