AMNIOTIC MEMBRANE TRANSPLANTATION IN THE TREATMENT OF SHIELD ULCER IN VERNAL KERATOCON JUNCTIVITIS.
DOI:
https://doi.org/10.52206/jsmc.2013.3.1.248-251Abstract
Objectives: To evaluate the efficacy and safety of amniotic membrane transplantation (AMT) for the
treatment of shield ulcer in vernal keratoconjunctivitis (VKC) with giant papillae.
Material and Methods: This retrospective study was conducted in the Department of ophthalmology
Hayatabad Medical Complex Peshawar from May 2009 to May 2010. In this study 30 patients of VKC with
shield ulcer were evaluated for a period of one year. Both gender of 3 - 26 years age patients were included in
this study. Patients were enrolled and informed written consent was taken. Amniotic membrane
implantation was performed in thirty patients with grade 2 or grade 3 shield ulcers unresponsive to
conventional medical treatment lasting an average of 14 weeks. Surgery was done under general anesthesia
using amniotic membrane as a therapeutic contact lens. Their record was maintained and all patients with
the mean 4 months follow-up were evaluated for about safety, efficacy, and side effect of the treatment.
Results: Thirty eyes of thirty patients with grade 2 shield ulcer with opaque base) and grade 3 (plaque like
lesions) not responding to steroid therapy with or without surgical debridement were enrolled. The ulcers
healed with disintegration or retraction of the membrane in all patients within 2 weeks. A significant
decrease in symptoms and complete reepithelialization of the corneal ulcers were observed in all cases
within the first 7 days. The eyes remain stable during a mean follow-up of 4 months, with no intraoperative
or postoperative complications. Absorption of amniotic membrane occurred with in 2 to 3 weeks time
leaving the underlying ulcer completely epithelized.
Conclusion: Amniotic membrane transplantation in combination with debridement is a safe and effective
surgical modality in the management of shield ulcers. Further studies are warranted to confirm the efficacy
of amniotic membrane transplantation in the management of shield ulcer.
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