ESCRS - PO323 - The Healing Power Of Amniotic Membrane Drops. A 100 Years Old Man Saved From An Ocular Perforation. Descemetocele Transformed Into A 550 Um Cornea.

The Healing Power Of Amniotic Membrane Drops. A 100 Years Old Man Saved From An Ocular Perforation. Descemetocele Transformed Into A 550 Um Cornea.

Published 2022 - 40th Congress of the ESCRS

Reference: PO323 | Type: ESCRS 2022 - Posters | DOI: 10.82333/g9h7-9019

Authors: Carlos Francisco Vargas* 1 , Jorge Pradas Chacon 2 , Asaad Moufad 2

1Ophthalmology Trainee,Hospital de Terrassa CST,Barcelona,Spain, 2Ophthalmologist. Cornea Department,Hospital de Terrassa CST,Barcelona,Spain

Purpose

To describe a case where amniotic membrane drops healed and controlled corneal tissue in an elderly man with an ocular perforation who was treated in first place with an injection of air in anterior chamber and fibrin glue sealant (Tissucol ®). In addition, amniotic membrane tissue graft was performed with no success.

Setting

We introduce a single case of one patient who were treated and followed in our Hospital Consorci Sanitari de Terrassa, Barcelona, Spain. We took series of anterior segment OCT (AS-OCT) and pictures to do the follow up.

Methods

A 100 years old man who came to our hospital with a corneal stromal thinning, seidel and atalamia because of a neurotrophic ulcer mistreated in other hospital.

To begin with we filled anterior chamber with some air and patched the corneal defect with fibrin glue sealant (Tissucol ®). Additionally, we put a contact lens and added some topical antibiotics, cycloplegic and artificial eye drops.

Three days later corneal tissue was thinner and about to get perforated. Due to the urgency, surgical intervention with amniotic membrane graft was performed with a caruncular anesthesia.

Two days later there was not amniotic membrane graft. Stromal thinning, and descemetocele was found. We started to introduce amniotic membrane eye drops to our treatment.

Results

Because of the age of the patient another surgery was not a choice for the family and we offer amniotic membrane drops four times a day as a treatment. We were not hopeful that this would work and the possibility of performing an evisceration was even raised.

We use amniotic membrane drops four times a day for 2 months. The patient was closely followed every week with AS-OCT. Healing of corneal tissue with amniotic membrane eye drops was remarkable, going from a thickness of 122 microns to 544 microns during the 2 months of treatment.

Conclusions

The use of amniotic membrane eye drops must be considered as a primary treatment in the healing of corneal tissue.

In elderly patients with no chances of a corneal transplant or another kind of surgery amniotic membrane drops should be considered due to facility do use.

Anterior segment OCT is an excellent way to follow up the corneal healing process using amniotic membrane drops.

The comparison between amniotic membrane drops with some other tissue (natural or artificial) should be perform in long term in order to stablished better protocols.