Surgical treatment of 32 cases of long-term atopic keratoconjunctivitis using the amniotic membrane

Abstract

PurposeTo evaluate the use of surgical treatment with amniotic membrane for long-term atopic keratoconjunctivitis. Damaged corneas were repaired with various techniques: amniotic membrane transplantations, amniotic membrane coverings, amniotic membrane fillings (AMFs), and amniotic membrane inlay fillings, the latter of which were combined with glycerol-preserved corneal transplants.MethodsThis retrospective study was conducted on 37 eyes belonging to 37 patients with atopic keratoconjunctivitis. Thirty-two patients were classified into four groups according to surgical technique. Five patients undergoing medical management served as controls. Surgical outcome was measured by recovery time and long-term visual improvement.ResultsIn all surgical eyes, integrity of ocular tissues was effectively restored and symptoms were reduced at 24.4±13 days post recovery. Mean best-corrected visual acuity improved from 0.6±0.2 to 0.198±0.16 logarithm of the minimum angle of resolution (P<0.001). There were no intraoperative or postoperative complications, with the exception of two recurring cases, both controlled by medication. Recovery time of the control groups lasted 52±16 days. In controls, mean best-corrected visual acuity improved from 0.74±0.15 to 0.54±0.29 logarithm of the minimum angle of resolution (P≤0.05). The vision improvement has significant difference for surgical treatment vs medical. (Mann-Whitney U-test, U=119, P<0.05, one tailed).Vision improvements remained stable during a mean follow-up period of 21.7±3.8 months.ConclusionPatients suffering from severe chronic atopic keratoconjunctivitis and its complications can benefit from suitable surgical treatments: transplants, covers, fillings, or corneal graft surgeries supplemented with AMFs. © 2013 Macmillan Publishers Limited.