[Tissue adhesive combined with amniotic membrane adhering in the treatment of ocular burns].

PURPOSE: To investigate the surgical technique and its usefulness of tissue adhesive combined with amniotic membrane adhering, a new surgical procedure for ocular burns.

METHODS

Thirty-four eyes from 29 patients with ocular burns participated in the study, grade II -III 9 eyes, grade IV 25 eyes . In 25 eyes with burn of grade IV, 7 eyes experienced complete (100%) limbal ischemia, 18 had partial (less than 100%) limbal ischemia, and 12 with severe conjunctival necrosis had sclera involved. Cyanoacrylate tissue adhesive combined with amniotic membrane adhering was applied after standard medical therapies failed in controlling the deterioration of patients' conditions. Our outcome measures included healing of the epithelial defect, resolution of the ulceration and inflammation, adhering of the tissue adhesive and amniotic membrane, and vision acuity.

RESULTS

outcome data were available for 33 eyes. For a follow-up of 2-6 months, All the 27 eyes showed epithelialization within 8-42 days, (23.9+/-8.0) days, including those with burns of grade II -Il , grade IV ( partial limbal ischemia). Corneal melting was arrested in 6 eyes with 100% limbal ischemia. Vision acuity was improved significantly in 29 eyes, had no change in the other 4 eyes.

CONCLUSION

Cyanoacrylate tissue adhesive combined with amniotic membrane adhering can rapidly restore both corneal and conjunctival surfaces, thus preventing effectively scarring sequelae in the late stage. In most severe burns, however, it arrests the corneosclera melting and restores the conjunctival surface and blood supply of the anterior segment, but does not restore the integrity of the corneal surface, which requires further limbal stem cell transplantation.