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Published on: September 12, 2014
Use of a hyperdried cross-linked amniotic membrane as initial therapy for corneal perforations
Kiyotaka Kitagawa1, Motonori Okabe, Shuichiro Yanagisawa
1Department of Ophthalmology, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.
Purpose:
To report the use of hyperdried cross-linked (HDCL) amniotic membrane (AM) patching with tissue adhesive as an initial therapy for corneal perforations.
Methods:
Cryopreserved AM was cross-linked with 0.1% glutaraldehyde and then dried using far-infrared rays and microwaves (hyperdry method). Three eyes of three patients with corneal perforations of up to 3 mm in diameter were included in this study. They were treated with a single-layer patch of HDCL-AM applied with a tissue adhesive (2-octyl-cyanoacrylate). We also evaluated the resistance of HDCL-AM to collagenases during in vitro digestion testing.
Results:
In all three cases, the corneal perforations were repaired within 28 days (range, 17-28 days). No recurrence occurred during the follow-up period (3-6 months). In the collagenase digestion testing, the HDCL-AM did not dissolve until 48 h, whereas the cryopreserved AM completely dissolved within 60 min.
Conclusions:
Three cases of corneal perforations were successfully managed using HDCL-AM patching with tissue adhesive. The HDCL-AM was resistant to collagenases during in vitro digestion testing. The HDCL-AM was a useful substrate for corneal perforations. This simple surgical technique may be one of the initial therapeutic options for corneal perforations.
