J Korean Ophthalmol Soc.  2004 Dec;45(12):1981-1988.

The Effect of Amniotic Membrane Transplantation on the Treatment of Necrotizing Scleritis after Pterygium Excision

• Jeoung JW
• Yoon YM
• Lee JL
• Wee WR
• Lee JH
• Kim MK

Abstract

PURPOSE
To investigate the efficacy of amniotic membrane transplantation (AMT) in patients who were diagnosed with necrotizing scleritis after pterygium excision and who were refractory to systemic corticosteroid and immunosuppressive therapy. METHODS: Six patients who had persistent scleral melting with systemic corticosteroid or immunosuppressive agents underwent double AMT as a permanent patch graft and temporary overlying barrier. Postoperatively, the symptom improvements, reepithelization times and visual acuity changes were evaluated. RESULTS: Choroidal detachment was detected in two patients preoperatively. In all patients, ocular pain improved at 4.7 +/- 3.1 days, and reepithelization of the scleral lesions was completed at 13.2 +/- 8.1 days postoperatively. Choroidal detachment in two patients disappeared at postoperative 2 and 8 days. Complete remission was found in 5 of the 6 eyes (83.3%). One eye which achieved full epithelization in the necrotic area experienced recurrent nodular scleritis in another quadrant, resulting in remission after changing the regimen of immunosuppressive agents. Mean values of initial and final visual acuities were 0.898 logMAR and 0.428 logMAR, respectively, and the visual acuities improved in all patients. CONCLUSIONS: AMT is effective in promoting reepithelization of the necrotic area, resulting in complete remission of necrotizing scleritis in patients who were refractory to systemic corticosteroid or immunosuppressive therapy.

Keyword

Amniotic membrane transplantation; Epithelization; Necrotizing scleritis; Patch graft

MeSH Terms

Amnion*
Choroid
Freezing
Humans
Immunosuppressive Agents
Pterygium*
Scleritis*
Transplants
Visual Acuity
Immunosuppressive Agents