Efficacy of Amniotic Membrane Transplantation for the Treatment of Corneal Ulcers. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Schuerch, Kaspar; Baeriswyl, Andrea; Frueh, Beatrice E.; Tappeiner, Christoph
• Is Part Of: Cornea. Volume 39:Issue 4(2020)
• Publication Date: 2020-04
• Subjects: amniotic membrane -- corneal ulcer -- corneal disease -- cornea -- amniotic membrane transplantation -- ocular surface disease; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000002179
• Languages: English
• ISSNs: 0277-3740

Abstract

Abstract : Purpose: To evaluate the outcome of amniotic membrane transplantation (AMTX) as a treatment for corneal ulcers. Methods: Patients treated with AMTX for refractory corneal ulcers between 2012 and 2017 were evaluated in a retrospective analysis. Primary outcome measure was complete reepithelialization. Results: A total of 149 patients were included (mean age 68 ± 18 years). The mean duration between ulcer onset and AMTX was 42 ± 46 days. The longest time between ulcer diagnosis and AMTX was found in bacterial ulcers and the shortest time to AMTX in eyes with trauma/chemical burns (mean 65 ± 15 days and 14 ± 4 days, respectively). In 70% of the patients, a single AMTX procedure was sufficient to achieve epithelial closure (21% <1 month, 40% within 1 –3 months, and 9% within 3–6 months). Treatment failure was observed in 30% of all patients, and most of them underwent further interventions. Highest closure rates were found in bacterial ulcers, herpetic ulcers, and neurotrophic ulcers (80%, 85%, and 93%, respectively), whereas the lowest reepithelialization rates were found in ulcers after corneal surgery and ulcers associated with rheumatic disease (52% and 57%, respectively). Conclusions: AMTX is a valuable treatment option to achieve corneal epithelial wound healing in cases refractory to conventional treatment. Success rates differ depending on the etiology of ulcer.