engleski

Pediatric keratoplasty combined with amniotic membrane transplantation – video

The authors present two cases of pediatric keratoplasty combined with amniotic membrane transplantation (AMT). In a first case corneal transplantation and secondary intraocular lens implantation was performed due to 9 years old corneolenticular trauma resulting in aphakia and corneal scar. Due to 1-quadrant corneal neovascularization, a peace of amniotic membrane was transplanted at the affected site to suppress regrowth of vessels into grafted cornea. Occlusion therapy of the contra lateral eye had been started at 1 postoperative week to treat amblyopia. Second case presents re-transplantation in a 12-year old girl that had previous graft 3 years ago due to herpetic corneal scar. At the time of re-transplantation all four corneal quadrants were heavily vascularized ; therefore AMT was placed over the corneal graft. Amniotic membrane resolved in 3 weeks preserving clear, non-vascularized corneal graft. Both tissues needed for surgery – optimal quality donor corneas and amniotic membranes were obtained from the Eye Bank. Diseased corneal buttons of both patients were examined in eye bank laboratory for the presence of pro-inflammatory cytokine IL-1 in corneal layers (epithelium, stroma and endothelium) to estimate inflammatory state of the eye at the time of surgery. Patient with rejected graft had high IL-1 level secretion from its cornea (>400 pg/ml), as opposed to patient with old corneal scar that had low IL-1 levels (<1 pg/ml) at the time of surgery. These results helped us in judgment of proper postoperative treatment and confirm the usefulness of the AM that secrets antagonist of IL-1 , interleukin-1 receptor antagonist (IL-1ra).

pediatric keratolasty ; amniotic membrane transplantation

nije evidentirano