Amniotic membrane transplantation- excellent biological scaffold for anterior ocular surface reconstruction

Abstract

Abstract Aim: To evaluate the clinical effect and to determine the correlation between the initial pathology and postoperative outcome in patients with anterior surface dysfunction treated by amniotic membrane transplantation (AMT). Material and Methods: 174 AMT of cryopreserved amniotic membrane (AM) performed on 128 patients over a period of two years (01.2014-12.2015). Patients were grouped into 7 cohorts according to the reasons for the AMT - A) corneal recurrent erosions (n = 32), B) postoperative keratitis (n = 7), C) neurotrophic ulcers (n = 14), D) trauma and burns (n = 30), E) bacterial keratitis (n = 10), F) viral keratitis (n = 19) and G) other (n = 16). The groups were assessed for levels of pain (subjective symptom) and hyperemia and size of corneal ulcer (objective signs), and were compared on several stages before and after AMT - day 0, day 8 and day 25. Results: The AM treatment resulted in significant reduction of the symptoms in all categories. On the 8 th day, the observed improvement was bigger than 50% (100% for the pain, 50±10% for hyperemia and 60±15% corneal ulcer) as at the end of our follow-up hyperemia bettering increased to 80±10% and corneal ulcer size decreased with 95±3% Interestingly, in comparison to day 8, pain levels increased significantly after 25 days of AMT to 15±15%. Conclusion: АМТ is an effective method for managing pathological conditions resulting of damage to the ocular surfaces such as unresponsiveness to common treatment, chronical or recurrent diseases, eye infection and stem cell deficiency. The application of this therapy can have permanent outcome, which results in complete healing of the damaged eye or can serve as a temporal procedure until reconstructive approach is possible. AMT is a treatment of choice in the cases where availability of the corneal tissue is limited.