Amniotic Membrane Transplantation in the Management of Corneal Ulceration Following Infectious Keratitis

Ocul Immunol Inflamm. 2023 Jul 7:1-7. doi: 10.1080/09273948.2023.2228901. Online ahead of print.

Abstract

Purpose: To report on the outcomes of amniotic membrane transplantation (AMT) for corneal ulceration following infectious keratitis.

Method: In this retrospective cohort study of 654 patients with culture-proven infectious keratitis from 8 hospitals in Galicia (Spain), a total of 43 eyes of 43 patients (6.6%) underwent AMT for postinfectious corneal ulceration. The indications for AMT were sterile persistent epithelial defects, severe corneal thinning or perforation.

Results: AMT was successful in 62.8% of cases, with 37.2% requiring an additional surgery. Median time to healing was 40.0 days (IQR 24.2-101.7 days) and final BCVA was lower than baseline (p = 0.001). Ulcers were large (>3 mm) in 55.8% of cases. Previous herpetic keratitis and topical steroid use were more common in patients who received AMT (p < 0.001). 49 microorganisms (43 bacteria and 6 fungi) were isolated.

Conclusions: AMT is a therapeutic option for complications following infectious keratitis, which present with a sterile persistent epithelial defect, significant corneal thinning or perforation.

Keywords: Amniotic membrane transplantation; cornea; keratitis.