Abraham SolomonDaniel MellerPinnita PrabhasawatThomas JohnEdgar M. EspanaKlaus Peter SteuhlScheffer C.G. TsengBascom Palmer Eye InstituteUniversitat Duisburg-EssenMahidol UniversityLoyola University of ChicagoChicago Cornea Research CenterUniversity of Miami Leonard M. Miller School of MedicineOcular Surface Center Miami2018-07-242018-07-242002-04-13Ophthalmology. Vol.109, No.4 (2002), 694-703016164202-s2.0-0036203777https://repository.li.mahidol.ac.th/handle/20.500.14594/20502Purpose: To describe the clinical outcome of amniotic membrane transplantation (AMT) for nontraumatic corneal perforations, descemetoceles, and deep ulcers. Design: Retrospective, noncomparative, interventional case series. Participants: Thirty-four eyes of 33 consecutive patients operated on for nontraumatic corneal perforations or descemetoceles at four academic departments of ophthalmology. Associated autoimmune disorders included rheumatoid arthritis (n = 6), Stevens-Johnson syndrome (n = 3), ocular cicatricial pemphigoid (n = 2), systemic lupus erythematosus (n = 1), and one eye with Mooren's ulcer, as well as neurotrophic, or exposure keratopathy (n = 10), postinfectious nonhealing ulcers (n = 6), and postsurgery (n = 5). Intervention: Three or four layers of amniotic membrane (AM) were applied over the ulcer bed and anchored with 10-0 nylon interrupted or running sutures. A large AM piece was used as a patch to cover the entire corneal surface. Main Outcome Measures: Formation of anterior chamber depth, epithelialization of the AM grafts, and stability of the corneal stromal thickness. Results: The mean follow-up period was 8.1 ± 5.7 (ranging from 2-23) months. A successful result was observed in 28 of 34 eyes (82.3%). Of the successful cases, 23 eyes needed one AMT procedure, whereas 5 eyes needed two procedures to achieve a successful result. In five eyes, a subsequent definitive surgical procedure such as penetrating keratoplasty or lid surgery was needed. Failure was observed in six eyes with rheumatoid arthritis, neurotrophic keratopathy, or graft melting. Conclusions: AMT is an effective method for managing nontraumatic corneal perforations and descemetoceles. It can serve as either a permanent therapy or as a temporizing measure until the inflammation has subsided and a definitive reconstructive procedure can be performed. This treatment option is also beneficial in those countries where corneal tissue availability is limited. © 2002 by the American Academy of Ophthalmology.Mahidol UniversityMedicineArticleSCOPUS10.1016/S0161-6420(01)01032-6