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Super-thick amniotic membrane grafts an alternative for ocular surface reconstruction
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Super-thick amniotic membrane grafts were easy to suture, were persistent and resulted in epithelialization of the ocular surface without primary symblepharon formation in patients with ocular surface abnormalities, according to a study.
“Super-thick amniotic membrane grafts are commercially available, less complicated and more comfortable than oral mucosa harvesting for significant conjunctival and forniceal reconstructions,” Paul T. Finger, MD, lead study author, told Healio.com/OSN.
The retrospective interventional case series evaluated the grafts for intraoperative handling, graft position at 1 week after implantation, graft dissolution at 3 weeks, epithelialization of the ocular surface and symblepharon formation.
The super-thick grafts were nine times thicker than standard amniotic grafts, such that 7-0 Vicryl sutures without cheese-wiring could be used.
Eleven super-thick amniotic membrane grafts were implanted after resection with cryotherapy, including five for conjunctival melanoma, four for squamous cell carcinoma, one for sebaceous carcinoma and one for atypical pterygium.
The super-thick grafts did not affect IOP or visual acuity. At 1 week, 100% of cases had a well-positioned graft in situ with intact sutures. At 3 weeks, 75% had partial graft dissolution and 25% had complete graft dissolution. Graft dissolution was related to air exposure. Complete epithelialization without wound dehiscence was achieved in all cases. Secondary symblepharon formed in two cases after additional tumor treatment.
At final follow-up of 25.5 months, complete local tumor control was achieved in 10 cases, and one case required orbital exenteration.
In a separate case of scleral necrosis due to the “Bright Eyes procedure,” revascularization was seen after treatment with the super-thick graft. – by Robert Linnehan
Disclosures: The authors report no relevant financial disclosures.
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