gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

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Modified fibrin sealing of multiple amniotic membranes in corneal perforation

Meeting Abstract

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  • corresponding author C. E. Uhlig - University Eye Hospital, Muenster
  • H. Busse - University Eye Hospital, Muenster

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 034

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog525.shtml

Published: September 22, 2004

© 2004 Uhlig et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

The combined use of amniotic membrane and fibrin glue was proposed to be a suitable method for the treatment of corneal perforation. However, the immediate coagulation of both of the fibrin components does not allow any further corrective manipulation of the membrane. We present a modified microsurgical procedure to overcome this difficulty.

Methods

Surgical procedure: 1. Regular debridement and removal of circumferential epithelium, 2. temporary placement of amniotic membrane on normal bulbar conjunctiva, 3. application of fibrinogen to the ulcer surface, 4. application of a small amount of thrombine to an intact part of the neighbouring cornea, 5. rotary movement of the amniotic membrane, first over the thrombine component and then to the ulcer as a graft (step 2-5 might be repeated with several membranes), 6. application and suture of an overlying amniotic membrane.

Results

Three patients suffering from monolateral corneal perforation were treated with 1 to 5 fibrin sealed amniotic membrane grafts. Difficulties in placing membranes even in complex ulcer configuration were not observed.

Conclusions

This application method allows to treat corneal perforation with multiple amniotic membrane grafts and avoids mechanical problems due to the immediate coagulation of fibrin sealant.