Abstract
PurposeThe use of amniotic membrane has been suggested in the treatment of infectious keratitis for its intrinsic anti-infective properties probably mediated by its anti-inflammatory effects. The aim of this study was to investigate the effect of amniotic membrane transplantation (AMT) along with ciprofloxacin to cure the primary stages of Pseudomonas keratitis.MethodsIn total, 28 rabbits were selected and divided in four groups as follows: group 1 as control, group 2 with amniotic membrane, group 3 with ciprofloxacin, and group 4 with amniotic membrane combined with ciprofloxacin. About 0.05 cc suspension of Pseudomonas aeruginosa, 27853 ATCC was injected into corneal stroma.ResultsThe results showed groups of AMT, AMT + ciprofloxacin, and ciprofloxacin had 0% perforation while the control group had 85.6%. Average infiltration of 5.5 mm was observed in ciprofloxacin group, 5 mm in AMT + ciprofloxacin group, 24 mm in AMT group, and finally 23.75 mm for control. Amniotic membrane showed to be effective in prevention of cornea perforation as well as remission of Pseudomonas keratitis. There was no significant difference between ciprofloxacin groups in comparison with ciprofloxacin + AMT group. However, regarding the anti-inflammatory effect, the process of improvement of inflammation in ciprofloxacin + AMT group was faster.Conclusion Transplantation of amniotic membrane in the primary stages of Pseudomonas keratitis treatment remarkably prevents the disease and it can be used to control its process.
Highlights
METHODSHuman amniotic membrane (AM) forms the inner wall of the membranous sac that surrounds and protects the embryo during gestation.It consists of a single layer of ectodermally derived columnar epithelial cells attached to a basement membrane with an underlying layer of mesenchyme.[1]
The aim of the current study was to investigate the effect of Amniotic membrane transplantation (AMT) along with ciprofloxacin to cure the primary stages of Pseudomonas keratitis
Few studies have investigated the effect of AMT in the surgical treatment of severe infectious keratitis with corneal ulceration or perforation.[19, 23, 27]
Summary
It consists of a single layer of ectodermally derived columnar epithelial cells attached to a basement membrane with an underlying layer of mesenchyme.[1] Amniotic membrane transplantation (AMT) is widely used in various ocular surface diseases such as neurotrophic keratitis and persistent epithelial defects,[2, 3] band keratopathy,[4] bullous keratopathy,[5, 6] after excimer laser photorefractive keratectomy,[7, 8] after the excision of a conjunctival mass,[9, 10] pterygium,[11, 12] ocular surface reconstruction in symblepharon,[13, 14] acute chemical injury,[15, 16] and a chronic limbal deficiency.[17, 18] When used as a graft (epithelial side up), AM is expected to become incorporated in the recipient tissue If it is used as a patch (epithelial side down), it works as a biological bandage affording a cover for a limited duration or a combination of these. The use of AM has been suggested in the treatment of infectious keratitis because of its intrinsic anti-infective properties probably mediated by its anti-inflammatory effects and because AM may act as a long-term drug delivery system.[19,20,21] The antimicrobial effects of AM have been demonstrated against several species such as Escherichia coli, Group A Streptococci, Pseudomonas aeruginosa, and Staphylococcus aureus.[22, 23] AM graft for epithelial reformation has been employed in order to eradicate the P
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