Amniotic membrane transplantation in refractory corneal ulcers. A randomized, controlled clinical trial

Abstract

This study compared the efficacy of amniotic membrane transplantation with conventional management (tarsorrhaphy and bandage contact lens) in eyes with refractory neurotrophic corneal ulcers. Thirty eyes of 30 patients (14 males and 16 males; mean age = 37 ± 14.71 years) with neurotrophic corneal ulcers that had persisted for at least 4 weeks and were sterile on microbiologic examination were included and randomly divided into group 1 (n = 15), who received conventional management with a tarsorrhaphy (n = 11) or bandage contact lens (n = 4), and group 2 (n = 15) who underwent amniotic membrane transplantation (AMT). At the end of 3 months of follow-up, 10 (66.7%) eyes in group 1 and 11 (73.3%) eyes in group 2 showed complete re-epithelialization (P > .05). The median time for re-epithelialization in both groups was 21 days. Both groups showed similar improvement in best-corrected visual acuity. The conclusion was that both conventional therapy and amniotic membrane transplantation are effective treatment modalities for refractory neurotrophic corneal ulcers.—Michael D. Wagoner