Microscopic corneal epithelial changes and clinical outcomes in simple limbal epithelial transplantation surgery after treatment with amniotic membrane eye drops (AMED): A case report

Erika Bonacci; Raphael Kilian; Clara Rizzo; Alessandra De Gregorio; Francesca Bosello; Adriano Fasolo; Diego Ponzin; Giorgio Marchini; Emilio Pedrotti

doi:10.1016/j.ajoc.2022.101763

Microscopic corneal epithelial changes and clinical outcomes in simple limbal epithelial transplantation surgery after treatment with amniotic membrane eye drops (AMED): A case report

Am J Ophthalmol Case Rep. 2022 Nov 30:29:101763. doi: 10.1016/j.ajoc.2022.101763. eCollection 2023 Mar.

Authors

Erika Bonacci¹, Raphael Kilian¹, Clara Rizzo¹, Alessandra De Gregorio², Francesca Bosello¹, Adriano Fasolo^{1

3}, Diego Ponzin³, Giorgio Marchini¹, Emilio Pedrotti¹

Affiliations

¹ Ophthalmic Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.
² Ophthalmic Unit, San Bassiano Hospital, Bassano del Grappa (VI), Italy.
³ The Veneto Eye Bank Foundation, Venice, Italy.

Abstract

Purpose: To describe the microscopic epithelial changes and the clinical outcomes of a patient treated with amniotic membrane eye drops (AMED) because of a persistent epithelial defect (PED) and a partial limbal stem cell deficiency (LSCD) after simple limbal epithelial transplantation (SLET) and deep anterior lamellar keratoplasty (DALK).

Observations: A 72-year-old patient, who had previously undergone SLET and DALK due to a total LSCD, presented with a PED related to a partial LSCD, and was treated with AMED for one month. We evaluated the patient's visual acuity, the Oxford grading scale, the Wong-Baker Pain Rating Scale, and in vivo confocal microscopy, both at baseline and 3 months after the end of treatment. Visual acuity improved from 0.5 to 0.4 LogMAR, the Oxford grading scale changed from grade III to grade I and the Wong-Baker Pain Rating Scale from grade 4 to grade 1. The corneal surface, which initially showed conjunctival characteristics over approximately 50% of the whole area, consisted mainly (75%) of mature corneal epithelium 3 months after the end of treatment.

Conclusions and importance: While improving symptoms and clinical characteristics, AMED was also able to restore the normal corneal epithelium's morphology in a case of partial LSCD after SLET and DALK.

Keywords: AMED; AMEED; Amniotic membrane; Amniotic membrane eye drops; Limbal stem cell deficiency; Simple limbal epithelial transplantation.

Publication types

Case Reports