[Results of using biocoating by means of the amniotic sac. Communication 2. Biocoating for the treatment of keratitis].

The amniotic sac has recently come into wide use to treat patients with various corneal lesions. Its suture fixation to the conjunctiva has proven to be inadequate, which limits its therapeutic effect. It is not quite expedient to use a donor corneoscleral flap for amniotic sac fixation in the existing shortage of a plastic material for keratoplasty. Longer retention of the amniotic sac on the involved cornea is achieved by the authors' technology that is to prescarify the ulcerated corneal surface, to set the preserved amniotic sac onto the surface, by grasping the limbal region of a graft, to place a ring-shaped donor layer or full-thickness corneoscleral flap cut out of a donor eye from which a corneal graft has been previously taken to be transplanted to another patient, to fix a ring-shaped flap together with the amnion with 8-00 interrupted sutures to the conjunctiva and episclera of a patient's eye. Twenty-nine patients with long non-healing corneal surface layer defect were operated on. Ten days after biocoat removal, complete corneal epithelization was revealed in 21 patients, defect substantially reduced in 8 patients, in them complete epithelization occurred in the outpatient setting following 5-7 days.

[Results of using biocoating by means of the amniotic sac. Communication 1. Keratoplasty with graft biocoating].

To protect a corneal graft at keratoplasty from tear moisture hyperhydration of the de-epithelized surface and from the negative exposure to contact with the eyelid mucosa in order to enhance surgical efficiency, the authors have developed a few biocoating technologies that involve amnionic sac placement on the graft, with its fixation on the eye of a recipient, by applying a full-thickness and layered corneal disc autologous flap or a ring-shaped allogenic corneoscleral one. Fifty-two patients (55 eyes) with primary (n=5) and secondary (n=33) corneal dystrophy and leukomas (n=14) were operated on. Penetrating keratoplasty and layer-by-layer grafting were performed in 38 (40 eyes) and 14 (15 eyes) patients, respectively. The biocoat was removed from the graft following 5-7 days; by that time complete epithelization of its anterior surface occurred in the majority of patients. After penetrating keratoplasty and layer-by-layer grafting, there was a transparent engraftment in 92.5 and 93.3% of patients, respectively. Visual acuity up to 0.2-0.6 restored in 74.5% of patients.