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We appreciate the interest and comments of Gatzioufas and associates concerning our article, 1 Nubile M. Dua H.S. Lanzini M. et al. In vivo analysis of stromal integration of multilayer amniotic membrane transplantation in corneal ulcers. Am J Ophthalmol. 2011; 151: 809-822 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar “In Vivo Analysis of Stromal Integration of Multilayer Amniotic Membrane Transplantation in Corneal Ulcers,” and for bringing the important point of amniotic membrane transplantation in manifest or suspect herpetic keratitis to the readers' attention. As correctly pointed out by the authors, persistent corneal epithelial defects and sterile corneal ulcers and melting often may be related to the protean clinical expression of herpetic infection of the eye. In Vivo Analysis of Stromal Integration of Multilayer Amniotic Membrane Transplantation in Corneal UlcersAmerican Journal of OphthalmologyVol. 153Issue 2PreviewNubile and associates recently published an interesting study evaluating the integration of amniotic membrane into the corneal stroma after amniotic membrane transplantation for persistent noninfectious corneal ulcers.1 The authors investigated the integration patterns of amniotic membrane using laser scanning in vivo confocal microscopy and anterior segment optical coherence tomography. They documented that integration of amniotic membrane into the corneal stroma is preceded by epithelialization over the amniotic membrane covering the ulcer and that the integrated amniotic membrane undergoes progressive modifications characterized by early loss of amniotic epithelial cells, changes in fibrillar structure, and repopulation by corneal stroma-derived cells. Full-Text PDF