Amniotic Membrane Transplantation After Symblepharon Lysis

Purpose: To describe the surgical techniques of amniotic membrane transplantation (AMT) for ocular surface reconstruction after symblepharon lysis. Methods: The surgical techniques involve excision of symblepharon, recession of the overlying conjunctiva to the fornix, and AMTwith fibrin glue to cover the bare sclera and line the fornix in mild and moderate cases. Additional oral mucosa graft is used to compensate for shortage of palpebral conjunctiva in severe cases. Mitomycin C is also applied in selective cases. Results: In mild and moderate symbleraphon, AMT was sufficient to replace the bulbar conjunctiva and to reconstruct the fornix. Postoperatively, patients recovered smooth and stable ocular surface, deep fornix, and full ocular motility without recurrence. Additional use of intraoperative mitomycin C significantly enhanced the success of AMT. In severe cases, oral mucosa graft is needed to substitute the peritarsal palpebral conjunctiva. Conclusions: AMT can be considered in the prevention and treatment of symblepharon. Effective surgical strategy may be tailored according to the severity. (Tech Ophthalmology 2010;8: 72Y75)