The observation of curative effects of amniotic membrane transplantation surgery in treatment of refractory corneal ulcer

Abstract

Objective To study the clinical curative effect of amniotic membrane transplantation surgery in treatment of refractory corneal ulcer. Methods Thirty-seven patients (37 eyes) with refractory corneal ulcer that underwent amniotic membrane transplantation surgery were retrospectively analyzed, including 3 cases with bacterial corneal ulcer, 10 cases with viral corneal ulcer, 7 cases with immunity corneal ulcer, 4 cases with neuroparalytic corneal ulcer, 7 cases with atheromatous corneal ulcer, 3 cases with thermal burns, 3 cases with alkali burns. All the patients were treated with removal of the necrotic corneal tissue combining amniotic membrane transplantation surgery when the corneal ulcer were protracted course of disease. And the medical therapy was further used to treat the primary disease after the operation. The follow-up time was from 3 months to 6 months, and the visual acuity and intraocular pressure were reviewed regularly. Corneal ulcer healing, amniotic membrane ocular surface healing, the change of corneal stromal edema, corneal neovascularization with the slit lamp microscope, and the healing of corneal epithelium with sodium fluorescein staining were observed. Results Thirty-six eyes were cured with one surgery in 37 eyes of the 37 cases; 3 eyes with corneal ulcer perforation were cured, and 2 eyes were carried out double amniotic membrane transplantation including 1 case with matrix necrosis type simple viral corneal ulcer and 1 case with immunity corneal ulcer, and 1 case with matrix necrosis type simple viral corneal ulcer was cured by amniotic membrane transplantation and penetrating keratoplasty. The follow-up time was from 3 months to 6 months, corneal ulcer in 36 cases (36 eyes) were healing, the amniotic membrane was completely absorbed, the corneal mcul were formed. Postoperative visual acuity: 37 eyes maintained the original vision or were increased partly, including 18 cases were from hand move to count finger, 9 cases were from count finger to 0.1, and 10 cases were more than 0.12. Conclusions For those intractable corneal ulcer which is invalid by drug treatment, amniotic membrane transplantation is one of the effective methods to provide good opportunities for increased visibility corneal transplant. Key words: Amniotic membrane transplantation surgery; Refractory corneal ulcer