Treatment of ligneous conjunctivitis with amniotic membrane transplantation and topical cyclosporine.

Ligneous conjunctivitis (LC) is a rare form of bilateral chronic recurrent disease in which thick membranes form on the palpebral conjunctiva and other mucosal sites. We report the clinical features and describe the management of two cases. Case 1 was an 8-month-old patient with bilateral membranous conjunctivitis. Case 2 was a 5-year-old patient with unilateral membranous conjunctivitis, esotropia, mechanical ptosis and complicated cataract, and had been treated with a number of medications. Histological investigation of the membrane in both cases showed LC. Treatments with amniotic membrane transplantation and institution of topical cyclosporine have shown good response. There has been complete resolution of the membranes with no recurrence at the end of 40- and 28-month follow-ups, respectively. No treatment related side effects were seen. Thus, it appears that amniotic membrane transplantation and topical cyclosporine are effective alternatives for the treatment of LC.

Amniotic membrane dressing vs conventional topical antibiotic dressing hospitalized brun patients

Different natural and synthetic materials were used for temporary burn wound coverage; however, they are associated with disadvantages including high price which prohibit their widespread use, especially in developing countries. Among all, human amniotic membrane is the only easily available and cost free coverage. Its effects on burn wounds have been studied in this survey. One-hundred and twenty four patients with 20-50% second and third degree burns and without any other disease were randomly assigned into two groups. The first 61 patients [control group] underwent traditional method of dressing with silver sulfadiazine and gauze which were changed twice a day. The remaining 63 patients underwent dressing with human amniotic membrane [amnion group], being changed every 3-4 days. Patients in the control group had significantly lower albumin and needed more albumin infusion [231.80 +/- 234 gr. versus 111.51 +/- 143.82 gr.], received more blood transfusion [1.75 +/- 2.52 bags versus 0.65 +/- 1.18 bags], had significantly more intense pain and so received more narcotics than amnion group [7.97 +/- 12.85 doses versus 3.84 +/- 7.56]. Wound infection was higher in the control group [65.66% versus 46.91%] and so was the incidence of sepsis [24.62% versus 6.10%]. There was 8.53% mortality in the control group versus 0% in the amnion group. All of the above-mentioned differences were statistically significant. Amniotic membrane dressing in deep and more extensive burns leads to better homeostatic, immunologic and local results and because of its low price, its use is strongly recommended

Ultrastructural study of the neovagina following the utilization of human amniotic membrane for treatment of congenital absence of the vagina

We present an ultrastructural study of the utilization of human amniotic membrane in the treatment of congenital abscence of the vagina in 10 patients. All patients were surgically treated with application of an amniotic membrane graft using the modifified McIndoe and Bannister technique. Sixty days after surgery, samples of the vaginal neoepithelium were collected for transmission electron microscopy analysis. The ultrastructural findings consisted of a lining of mature squamous epithelium indicating the occurrence of metaplasia of the amniotic epithelium into the vaginal epithelium. The cells were arranged in layers as in the normal vaginal epithelium, i.e., superficial, intermediate and deep layers. There were desmosomes and cytoplasmic intermediate cytokeratin filaments, as well as some remnant features of the previous amniotic epithelium. These findings suggest that human amniotic membrane is able to complete metaplasia into squamous cells but the mechanism of this cellular transformation is unknown.