Long-term efficacy of glycerine-processed amniotic membrane transplantation in patients with corneal ulcer

Acta Ophthalmol. 2015 Sep;93(6):e481-7. doi: 10.1111/aos.12671. Epub 2015 Mar 15.

Abstract

Purpose: The aim of this study was to determine the long-term treatment efficacy of glycerine-preserved human amniotic membrane transplantation in patients suffering from corneal ulcers.

Methods: This was a retrospective, non-controlled, monocentric analysis. Included were patients with corneal ulcers that were non-responsive to ointment or contact lenses and had been treated by amniotic membrane transplantation with either the overlay or sandwich procedure. Analysis parameters were visual acuity before and following treatment, recurrence rate and subjective comfort at the last follow-up.

Results: Of the 371 amniotic membrane transplantations that were conducted, 135 surgical treatments in 108 patients (51.9% male, 48.1% female; mean age 63.7 years) met the inclusion criteria. In total, 99 overlay and 36 multilayer amniotic membrane transplantations were performed. The follow-up period was 47.5 ± 66.7 weeks (mean ± SD). The recurrence rate at the last follow-up was 47.8% with overlay membranes and 51.8% with the sandwich technique. There was no significant change in best-corrected visual acuity following treatment with overlays (p = 0.219) or sandwich procedure (p = 0.703). At the last follow-up, 72.1% (overlay) and 78.3% (sandwich) of the patients reported either no pain or increased comfort.

Conclusion: The recurrence rates and changes in visual acuity following overlay or sandwich amniotic membrane transplantation in patients suffering from corneal ulcer were lower than reported elsewhere in the literature. More than half of the patients profited from each of the amniotic membrane transplantation techniques with respect to recurrence and postoperative comfort.

Keywords: Neurotrophic ulcer; amniotic membrane transplantation; corneal ulcer; ocular surface disease; overlay; patch.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Amnion / transplantation*
  • Biological Dressings*
  • Child
  • Corneal Ulcer / diagnosis
  • Corneal Ulcer / physiopathology
  • Corneal Ulcer / surgery*
  • Female
  • Follow-Up Studies
  • Glycerol*
  • Humans
  • Male
  • Middle Aged
  • Nylons
  • Organ Preservation Solutions*
  • Recurrence
  • Retrospective Studies
  • Suture Techniques
  • Sutures
  • Visual Acuity / physiology

Substances

  • Nylons
  • Organ Preservation Solutions
  • Glycerol