Corneal melt after amniotic membrane transplant.

PURPOSE: To report an eye-threatening complication associated with amniotic membrane grafting. DESIGN: Interventional case report. METHODS: Retrospective review of the clinical and surgical records of a 43-year-old man who developed melting of his corneal graft after amniotic membrane transplantation. RESULTS: Melting of a corneal graft after amniotic membrane transplantation was arrested by utilizing a tectonic, full-thickness corneal button denuded of endothelium in conjunction with a temporary tarsorraphy and systemic steroids. CONCLUSIONS: To the best of our knowledge, this is the first report of an eye-threatening complication associated with amniotic membrane grafting. Caution should be exercised in utilizing amniotic membrane in patients who have undergone multiple ophthalmologic surgical procedures, which may sensitize the ocular immune system or lead to localized ischemia.

Regression of presumed primary conjunctival and corneal intraepithelial neoplasia with topical interferon alpha-2b.

PURPOSE: To evaluate topical interferon alpha-2b (IFNalpha2b) as a lone therapy in the treatment of primary conjunctival and corneal intraepithelial neoplasia (CIN). METHODS: Noncomparative, prospective, interventional case series. Seven patients from three institutions, treated between February and October 1999, with presumed primary CIN lesions (clinically diagnosed by corneal specialists) were given topical IFNalpha2b drops (1 million units/mL) four to six times daily. Follow-up was performed biweekly until there was complete clinical resolution of the presumed CIN lesions. Patients were to continue topical IFNalpha2b drops for 1 month after clinical resolution. Patient charts and clinical photographs were reviewed, and data were analyzed. RESULTS: All seven eyes had complete resolution of the presumed CIN lesions after an average of 77.0 +/- 59.2 days (range, 28-188 days). Average posttreatment follow up was 12.4 +/- 2.5 months (range, 9-16 months). No patients were lost to follow-up. No recurrences have yet been seen. Side effects of treatment were limited to mild conjunctival hyperemia and follicular conjunctivitis in four (57.1%) eyes. In all cases, there was total resolution of conjunctival hyperemia and follicular changes within 1 month after cessation of the medication, without additional treatment. CONCLUSIONS: Topical IFNalpha2b alone may be an effective treatment of primary CIN. It appears to be a safe alternative to radiation, intralesional IFNalpha2b injection, and surgical excision with cryotherapy. Larger population studies with longer follow-up are recommended to better assess the risk of recurrence and other possible adverse effects.