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BACKGROUND Corneal ulcer is one of the most common causes of corneal blindness. This study aimed to describe the outcomes of amniotic membrane transplantation (AMT) in patients with infectious corneal ulcer. METHODS A retrospective cohort study based on medical records of patients who underwent an adjuvant AMT procedure over a 2-year period (2015--2017) was conducted at Cipto Mangunkusumo Hospital Jakarta. Uncorrected visual acuity (UCVA) was measured with the Snellen chart. Treatment success was marked by complete healing (disappearance of corneal infiltrates, epithelial defect closure, and corneal scar formation). Healing time was the duration from AMT surgery to complete healing. RESULTS 50 cases of infectious corneal ulcer, 12 of which had perforation were included. Gram-positive cocci (18%), gram-negative rods (14%), fungi (4%), and Acanthamoeba (2%) were isolated from culture specimens. Successful results were observed in 90% of cases (20/21 moderate cases and 25/29 severe cases). Healing time was 21 (14--63) days in moderate cases and 28 (14--90) days in severe cases. Baseline UCVA improved from 2.48 (0.22--2.80) logMAR to 1.30 (0--2.80) logMAR within 3--4 weeks postoperatively and to 0.94 (0--2.80) logMAR at the last follow-up. Post-AMT complications included recurrent perforation in 4 eyes, persistent epithelial defects in 2 eyes, amniotic membrane infection in 1 eye, and membrane retraction in 1 eye. CONCLUSIONS AMT was successfully used to treat moderate and severe infectious corneal ulcer, particularly in nonresponsive and some perforated cases. AMT provides biochemical and mechanical support for corneal wound healing with good visual outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND Minimizing inflammation on the ocular surface after pterygium surgery is essential to prevent recurrence. Currently, limited data are available for the comparison between freeze-dried amniotic membrane (FD-AM) and conjunctival-- limbal graft (CLG). Therefore, this study aimed to assess conjunctival inflammation and the interleukin (IL)-6 levels in tears after pterygium excision between both techniques. METHODS This prospective, single-blinded, randomized clinical trial included 26 eyes of 26 patients with primary or recurrent pterygium and who were indicated for pterygium surgery at Cipto Mangunkusumo Hospital, Indonesia from October 2017 until February 2018. The patients were scheduled for pterygium excision with FD-AM or CLG based on block randomization. Conjunctival inflammation and the level of IL-6 in tears were measured on day-7 and -28 after surgery. RESULTS The 26 eyes (13 in each group) were subjected to a complete 1-month followup period. Day-7 after the surgery, severe inflammation occurred in 4/13 (31%) eyes having FD-AM and 8/13 eyes (62%) having CLG (p = 0.59). The IL-6 tear level increased similarly in FD-AM (22.85 pg/ml) and CLG (23.51 pg/ml) in (p = 0.78). No severe adverse events occurred. CONCLUSIONS Pterygium excision using FD-AM yield a milder inflammation than CLG on day-7 and -28 after surgery. The tear IL-6 levels similarly increased on day-7. [ABSTRACT FROM AUTHOR]

Abstract Current gold standard treatment of Buschke-Löwenstein tumor (BLT) is surgical excision. Surgical excision in the perianal region leaves a large area to be covered and bears the risk of poor wound healing as well as infection. Dehydrated human amnion/chorion membrane (dHACM) has been proven to be beneficial in wound closure and has been used in many cases, such as deep ulcers, ophthalmological surgeries, tendon repairs, etc. We report a case of 14-month old boy presented with mass from perianal region since six months prior to visit in Dr Soetomo General Hospital Surabaya. From physical examination, pedunculated exophytic growth with cauliflower-like appearance was found and because of the mass size, the anal opening and the rectum was difficult to be evaluated. CT scan obtained showed heterogenous solid mass with multiple calcification with size of ±7,62 × 6,58 × 3,12 cm in perineal cutaneous and subcutaneous tissue that encases the anus and anorectal area. Surgery was performed to remove the mass and the wound was closed with dHACM. Patient healed well without signs of infection nor excessive scarring. Hence, dHACM could be an excellent option in closing wound post excision in BLT cases. [ABSTRACT FROM AUTHOR]