Amniotic membrane extract for acute ocular chemical burns

Background: Ocular chemical burn induces devastating and permanent damage to the ocular surface. Rapid intervention is required for maximal visual rehabilitation. Amniotic membrane transplantation may save the ocular surface, however it introduces a potentially unnecessary surgical trauma in such compromised eyes. Amniotic membrane extract (AME) could be a practical substitute of amniotic membrane transplantation in acute chemical burn. Aim: The objective of the study was to evaluate the efficacy of topical AME in the management of acute ocular chemical burn. Methods: This is a noncomparative interventional case series. Four consecutive patients (6 eyes) with mild to moderate acute chemical burn, exhibiting persistent epithelial defect, inflammation, and haze despite extensive conventional therapy, were recruited. Topical AME was prepared and added to the conventional treatment within 2 days of the injury. Pain relief, inflammation, haze, and corneal epithelial healing were monitored. Results: Pain was significantly relieved, and inflammation was markedly reduced in all cases. The corneal epithelial defect rapidly healed, whereas visual acuity improved within 11 days (range, 4-23 days). During an average follow-up period of 6 months (range, 3-8 months), all eyes retained stable surface with improved corneal clarity without neovascularization or symblepharon. Conclusions: Topical application of AME could be an effective adjunct in the treatment of mild to moderate cases of acute chemical burns. It allows nontraumatic and early intervention to promote epithelialization; reduce pain, haze, and inflammation in acute phase; and prevent cicatricial complications in chronic phase. Future controlled studies with larger series may be considered to evaluate the overall efficacy and long-term results of such treatment. Currently, AME is not approved by the US Food and Drug Administration. Copyright © 2010 by Lippincott Williams & Wilkins.