To analysis the early efficacy of multiple amniotic membrane transplantation in the treatment of severe ocular alkali burn

Objective To study the indication and therapeutic effect of multiple amniotic membrane transplantation in the treatment of severe ocular alkali burn. Methods We make a retrospective analysis of therapeutic effect of 20 cases (24 eyes) severe ocular alkali burn patients with early twice or more than twice amniotic membrane transplant treatment in our hospital from July 2004 to May 2007. Then observe ocular surface stability, epithelial healing, angiogenesis and visual activity after operation to further study the indication and times of multiple amniotic membrane transplantation in the treatment of severe ocular alkali burn. Results 20 patients (24 eyes), 9 eyes amniotic membrane dissolved between 7-14 days after second amniotic membrane transplant, and the amniotic membrane ablate after sutures out.Ocular surface inflammation was under control, fluorescein sodium showed corneal epithelial integrity and corneal limbal ischemia was improved. 11 eyes’ corneal epithelium still defect after two amniotic membrane, the diameter of it more than 3 mm or more, cornea limbal ischemia more than 1/4 quadrant, Then did the third transplantation, 3 eyes to four times amniotic membrane transplant,1 eye to 5 times.In which 2eyes after second amniotic membrane transplantion, each 3 eyes after 3, 4, 5 times, the epithelial still defect, and the eyelid segmental defect, conjunctival ischemia Obviously, so we did them permanence blepharorrhaphy; each 2 eyes in 3, 4, 5 times amniotic membrane transplantion found corneal stroma was autolysis, so we did them lamellar keratoplasty; 1 eye found the corneal stroma autolysis and peripheral corneal ulcer in the third amniotic membrane transplant, so we did conjunctival flap covering for it. Conclusion Severe ocular alkali burn should actively take multiple amniotic membrane transplantation for treatment in the early, multiple amniotic membrane transplant is very effective for the stability of ocular surface, but it should be closely observed to prevent corneal ulcer expansion and perforation occurred after blind many times of amniotic membrane transplantion.