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Amniotic membrane transplantation for reconstruction after excision of large ocular surface neoplasias

¹ Department of Ophthalmology, Bascom Palmer Eye Institute, FL, USA
² Department of Cell Biology and Anatomy, University of Miami School of Medicine, Miami, FL, USA
³ Department of Ophthalmology, Mahidol University, Bangkok, Thailand

Correspondence to:
Correspondence to:
Scheffer C G Tseng, MD, PhD, Ocular Surface Center, 8780 SW 92 Street, Suite 203, Miami, FL 33176, USA;
stseng{at}ocularsurface.com

Aim: To evaluate the clinical outcome of patients in whom ocular surface reconstruction was performed using amniotic membrane transplantation (AMT) after the excision of large (>20 mm square) ocular surface neoplasias (OSN).

Methods: A non-comparative interventional case series. In 16 eyes of 16 patients, excision of large OSN including conjunctival intraepithelial neoplasia (CIN), primary acquired melanosis, and malignant melanoma was followed by adjunctive cryotherapy and suturing of a single layer of amniotic membrane (AM) with the basement membrane side facing up to the healthy bordering tissue. Epithelial healing, complications, and tumour recurrences were analysed.

Results: During a mean follow up of 23.7 (SD 11, range 11–43) months, ocular surface healing was rapid and complete in all cases. One complication of pyogenic granuloma was noted. Tumour recurrence occurred in one out of 10 CIN cases (10%), no recurrences were observed in the patients with melanotic lesions.

Conclusions: AMT in lieu of conjunctival or mucosal autograft is an effective substrate for reconstructing the ocular surface following excision of large OSN. AMT is effective in managing large OSN by avoiding the complications that may be associated with conventional removal, specifically in cases where the limbal architecture is destroyed by surgical resection or adjuvant therapies.

Keywords: amniotic membrane transplantation; excision; ocular surface neoplasias

Abbreviations: AM, amniotic membrane; AMT, amniotic membrane transplantation; CIN, conjunctival intraepithelial neoplasia; CMM, conjunctival malignant melanoma; PAM, primary acquired melanosis; VA, visual acuity

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