In persistent corneal epithelium defects, autologous serum therapy can be considered as an effective and practicable therapy without adverse reactions. Especially in eyes after complicated penetrating keratoplasty the prognosis may be improved and more invasive treatment modalities such as botulinum toxin injection, amniotic membrane transplantation or (repeat) penetrating keratoplasty may be avoided. Definitive determinants for the success of this novel therapy have not been identified, yet. However, eyes with accompanying deep stromal defects do not seem to be good candidates.
Background/aims: Amniotic membrane transplantation (AMT) has become well established as a treatment for chronic epithelial defects, conjunctival reconstruction, and partial limbal cell deficiency. The aim of this study was to describe cases of corneal calcification following AMT and to search for risk factors that might predispose to this unusual finding. Methods: Details of 117 AMTs on 93 corneas of 91 patients with a follow up period of at least 1 month performed since 1999 were collected prospectively. In those with calcification clinical photographs were studied and the medical records retrospectively examined. Results: 15 calcifications in 117 AMTs (12.8%) were identified, occurring 3-17 (median 6.1) weeks after AMT, during a follow up period of 4-151 (median 25) weeks. Overall epithelial healing rate was 83%. Calcification covered a surface area between 0.7-40.5 mm 2 maximum size with varied morphology. The primary diagnosis was diverse. Risk factors included the use of phosphate eye drops and pre-existing calcification in the operative or other eye. No patient with a "patch" AMT developed calcification. Conclusions: Corneal calcification occurs after some cases of AMT. A common risk factor was the postoperative use of phosphate containing eye drops.
In persistent corneal ulcers, amniotic membrane transplantation should be considered in early stages to achieve permanent epithelial closure in a less inflamed eye thus avoiding penetrating keratoplasty à chaud or conjunctival flaps. However, in eyes with broad descemetocele especially following chemical burns, this treatment modality does not seem to be effective.
The difference between the 2 methods in the central endothelium-anterior IOL face distance was not significant (methods were equivalent), but the difference in the peripheral endothelium-anterior IOL face distance was. This may be the result of difficulty in obtaining the exact transition point between the IOL and the haptics by SP examination. The difference between the 2 methods in the IOL border-iris distance was also significant because of the irregularity of the iris surface; therefore, measurements were performed at different sites along this structure. The significant differences in the peripheral endothelium-IOL and IOL border-iris distances indicate that although both methods are useful, they are not equivalent.
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