Clinical efficacy of amniotic membrane transplantation in the treatment of various ocular surface diseases

Abstract 

Purpose

To investigate the efficacy of permanent amniotic membrane transplantation (AMT) for the treatment of various ocular surface diseases.

Methods

The medical records of 62 eyes from 58 patients who had undergone permanent AMT were reviewed. The amniotic patches were grafted for the treatment of neurotrophic ulcers (n=15), inflammatory corneal ulcers (n=15), scleral ulcers (n=11), painful bullous keratopathy (n=8) and pterygium as an adjuvant to a conjunctival autograft (n=13). Cryo-preserved or freeze-dried amniotic membrane (AM) were used. The overall success rate, the interval to epithelialization, pain-subsiding time, and complications were evaluated. The pain relief and the full epithelialization interval in the bullous keratopathy patients given the cryo-preserved AM were compared with those given the freeze-dried AM.

Results

The success rate in the patients with neurotrophic ulcer, inflammatory corneal ulcer, scleral ulcer and bullous keratopathy were 93.3%, 66.7%, 92.9% and 100%, respectively. A conjunctival autograft with AMT showed a 100% success rate without recurrence. The time to re-epithelialization was 24.4±24.2, 20.4±5.8, and 16.9±7.0 days in patients with neurotrophic, inflammatory and scleral ulcers, respectively (p=0.431). The pain relief interval in the cryo-preserved and freeze-dried AM group was 17.7 and 23.3 days, and the re-epithelialization interval was 29 and 22 days, respectively, which was insignificant.

Conclusions

AMT has a high success in the treatment of neurotrophic, scleral ulcer, bullous keratopathy and pterygium with a low rate of complications but presented only partial success in the treatment of inflammatory corneal ulcers. The clinical efficacy of AMT was not related to the methods used to preserve the AM.

Keywords: Amniotic membrane transplantation, Corneal ulcer, Scleral ulcer, Bullous keratopathy, Pterygium