the role of amniotic membrane transplantation in severe ocular chemical burns

purpose: to evaluate the effect of aamniotic mmembrane ttransplantation (amt) in the management of acute severe ocular chemical burns. methods: this randomized clinical trial was performed in eligible patients with grade iii & iv acute chemical burn who randomly received conventional medical therapy (15 eyes) versus combined medical & amniotic membrane transplantation (15 eyes). main outcome measures were corneal epithelial healing time and improvement in perilimbal ischemia. secondary outcome measures included visual acuity, corneal transparency, vascularization, symblepharon formation and complications. results: 30 eyes of 28 patients (26 males and 2 females) with a mean age of 25±6.8 years (12-49) were enrolled in this study. corneal epithelial defect healed within 74.41±48.07 days (22-180 days) in the amniotic membrane group versus 99. 67±36.8 (56-170 days) in controls (p= 0.163). perilimbal ischemia improved in 76. 41±42.8 days in the amniotic membrane group versus 89. 16±44.6 days in the control group (p= 0.482). mean final visual acuity was 0.024±0.655 logmar versus -0.072±0.5 logmar in the amniotic membrane and control groups, respectively (p= 0.655). in the amniotic membrane group, symblepharon developed in 6 eyes versus 10 eyes in the control group. totally 3 eyes developed corneal perforation whom undergone tectonic corneal graft. conclusion: compared to conventional medical therapy, combined amt and medical therapy does not improve perilimbal ischemia or accelerate corneal epithelization. it also does not decrease corneal vascularization or improve visual acuity.