Self-retained cryopreserved amniotic membrane for treating severe corneal ulcers: a comparative, retrospective control study

Abstract

To compare the effectiveness of self- retained cryopreserved AM as an adjuvant therapy for infectious corneal ulcers. Retrospective, case–control study of 24 eyes of 24 consecutive patients with central and paracentral corneal infectious ulcers and initial visual acuity worse than 20/200. Among them, 11 eyes of 11 patients received additional placement of self-retained cryopreserved AM. Epithelialization and Best Corrected Snellen Visual Acuity (BCSVA) were compared between the two groups. At baseline, both groups had comparable age, gender, visual acuity (VA), size and location of corneal ulcer. Patients receiving additional placement of cryopreserved AM had significantly faster epithelialization within 3.56 ± 1.78 weeks vs 5.87 ± 2.20 weeks (p = 0.01) and achieved complete epithelialization in significantly more patients (72.7% vs 23.1% p = 0.04) despite overall larger baseline defect size (32.7 ± 19.5 mm2 vs 21.5 ± 10.7 mm2, p = 0.11). Consequently, the AM group had clinically significant BCSVA (> 3 lines) (81.8% vs 38.4%, p = 0.047) and total VA improvement (log MAR 0.7 ± 0.6 vs 1.6 ± 0.9, p = 0.016) compared to the control group at the time of complete epithelialization. In-office sutureless AM may be an effective adjuvant therapy in treating sight-threatening infectious corneal ulcers by promoting faster corneal epithelialization and overall better recovery of the VA.

Amniotic membrane transplantation in a patient with impending perforated corneal ulcer caused by Streptococcus mitis: A case report and review of literature

“…In a rabbit model, AM was proven to subside pseudomonas keratitis[ 21 ]. A previous report also showed the effectiveness of AM in the treatment of infectious corneal ulcer[ 22 ].…”

Visual Acuity and Number of Amniotic Membrane Layers as Indicators of Efficacy in Amniotic Membrane Transplantation for Corneal Ulcers: A Multicenter Study

“…Moreover, this gain may allow some of them to stop being blind (13.5%, 17/126), with all that this visual improvement entails clinically, as we have been able to observe in our results. HC-HA/PTX3’s anti-scarring and anti-angiogenic effects of AM could help explain the VA improvements [ 16 , 21 , 62 ].…”

Amniotic membrane use for resistant infectious and non-infectious corneal ulcer

“…It may be fixed with surgical sutures or with a removable carriage equipment like PROKERA, a bandage that fits over the surface of the cornea. With proven effectiveness on resistant infectious keratitis and is used as well established protocol of management in Tanta university hospital in Egypt, also use of cryopreserved amniotic membrane in cases of bacterial keratitis was studied by Yin HY on 2020 with excellent results [20,21] .…”