To study the efficacy of amniotic Membrane transplantation in ocular Surface disorder

Abstract

INTRODUCTION ABSTRACT Preserved human amniotic membrane ( AM) is currently being used for a wide surface disorders of the eye. The AM has a basement membrane, which promotes epithelial cell migration and adhesion. The presence of a unique avascular stromal matrix reduces inflammation, neovascularization and fibrosis. The basic tenets of amniotic membrane transplantation ( AMT ) are to promote re-epithelialisation, to reconstruct the ocular surface and to provide symptomatic relief from surface aberrations. AMT is a useful technique for reconstruction of surface defects resulting from removal of surface tumors and symblepharon. AMT has effectively restored a stable corneal epithelium in eyes with persistent epithelial defects( PED ) and corneal ulcers. In the setting of acute ocular burns and SJS, AMT has satisfactorily reduced scarring and inflammation. AMT alone may be an effective alternative for partial Limbal stem cell defiency ( LSCD ) . However, remarkable improvements in surface stability have resulted from concurrent use of AMT and limbal stem cell transplantation, wherein the limbal grafts are obtained from the normal fellow eye, living relative or cadaveric eye. MATERIALS AND METHODS All patients attending outpatient department of ophthalmology including referred cases from KLE’s PKH & MRC. Subjects for present study were selected by applying the inclusion and exclusion criteria. X RESULTS: Among 30 eyes of different ocular surface disorders selected in the study, AMT was successful in 86.6% cases of Primary progressive pterygium . Seventy five percent of the cases of Cicatrising conjunctivitis presenting in acute stages, showed good acceptance of the graft . However immunosuppressant’s played a crucial role in maintaining ocular surface integrity. In only 33.3% cases of Chemical burns, the graft showed satisfactory results. In Symblepharon cases,the traumatic symblepharon showed success with no recurrence. In the 2 cases of PED, Persistant Epethilial Defect secondary to KCS, AMT was successful. Lastly a single case of OSSN ,showed no recurrence of the growth post AMT. INTERPRETATION AND CONCLUSION: In this study of AMT for various ocular surface disorders were observed that there was overall success rate of 66.66 % which is comparable to earlier studies by various authors with rapid healing and reduction of ocular surface inflammation following AMT which can be explained by various mechanisms, as a result AMT becomes an attractive alternative for country like our’s where there is shortage of tissues. Hence AMT is used either as a substrate or patch graft, to replace ocular surface. Lastly efficacy of AMT is better in ocular surface disorders.