Long-term symptomatic relief of bullous keratopathy with amniotic membrane transplant

Abstract

The purpose of this study was to assess the long-term outcome of patients with symptomatic bullous keratopathy after amniotic membrane transplant. A retrospective cohort study includes that 20 patients with symptomatic bullous keratopathy, who have underwent amniotic membrane transplant at the Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Hospital, Hong Kong between 04/1998 and 06/2011, were invited back. Clinical examination was performed, including, pain score assessment (pain score out of 10), epithelial healing, and vision. A total of 21 eyes of 20 patients returned for our study. The majority of eyes experienced pain reduction (94 %), with a significant mean pain score difference of 6.8 ± 2.6, 2-tail p < 0.001 (99 % CI 4.9-8.7). The mean pre-operative and post-operative pain scores were 7.3 ± 2.9 and 0.5 ± 1.0, respectively. 16 eyes (76 %) were completely pain free, and 10 eyes (47 %) remained symptom free after a mean follow-up of 39.0 ± 36.3 months (range 5-171 months). The median epithelial healing time was 2 weeks (range 1-20 weeks). Amniotic membrane transplant may be considered as a longer-term treatment for bullous keratopathy patients, especially in patients with poorer visual prognosis, but it may also be used as an interim measure for patients awaiting corneal transplant.

Fetal mesenchymal stem cells ameliorate acute lung injury in a rat cardiopulmonary bypass model

“…Neutrophil infiltration to the interstitial space of the lung was significantly lower in the MSC group compared with the control group (sham group vs control group vs MSC group; 23.2 AE 7.8 vs 40.3 AE 5.3 vs 28.3 AE 4.9 cells, P ¼ .03 in the control vs MSC; Figure 3, B). According to semiquantitative grading, 20,21 the lung injury score was significantly lower in MSC group compared with those in the control group (control group vs MSC group; 6.9 AE 1.6 vs 4.7 AE 0.8, P ¼ .02; Figure 3, C). As shown in Figure 3, C, alveolar airspace ratio in the MSC group was significantly greater than in the control group (control group vs MSC group; 43.2 AE 3.3% vs 55.1 AE 3.6%, P ¼ .004) (Figure 3, D).…”

Amniotic Membrane Transplantation an Experience of a Locally Prepared Tissue

“…They had follow-up that exceeded 12 months and had success rate of 94% in terms of pain relief. 36 We used the overlay technique for PBK. Our results showed 75% success rate at 12 months follow-up.…”

Palliative Efficacy of Intrastromal Amniotic Membrane Procedure in Symptomatic Bullous Keratopathy Patients

“… 14 The intrastromal hAM technique is one of the treatment alternatives for symptomatic BK cases with limited visual potential. 12 With this procedure, hAM acts as a barrier for the corneal epithelium and effectively prevents corneal edema associated with endothelial failure from causing ocular surface disease. 12 , 15 In this technique, hAM prepared to the size of the damaged area acts as a basement membrane for corneal epithelial cell proliferation and suppresses subsequent inflammation by reducing contact with tear-induced mediators.…”

“…One of these is the inlay technique, in which the amniotic membrane is applied intra- or suprastomally. 12 …”