Amniotic Membrane Transplantation Research Articles

Surgical Treatment of Corneal Shield Ulcer in Vernal Keratoconjunctivitis: A Systematic Review.

Vernal keratoconjunctivitis (VKC) severely affects the quality of life of affected patients. The development of a shield ulcer is considered one of the most severe late-stage complications, which when untreated leads to irreversible vision loss. In this systematic review, we outlined the results of surgical treatments of corneal shield ulcers in VKC. We searched 12 literature databases on 3 April 2023 for studies of patients with VKC in which shield ulcers were treated by any surgical treatment. Treatment results were reviewed qualitatively. Assessments of the risk of bias of individual studies were made using the Clinical Appraisal Skills Programme. Ten studies with 398 patients with VKC were eligible for the qualitative review. Two categories of surgical approaches were described: supratarsal corticosteroid injection and debridement with or without amniotic membrane transplantation. Almost all patients experienced resolution or improvement of their shield ulcers, regardless of treatment modality. Time to healing was faster with surgical debridement. A small proportion experienced recurrence and side effects. Surgical treatment for shield ulcers in VKC seems highly effective, but careful post-operative treatment and follow-ups are necessary due to the risk of recurrence and potential side effects.

Postkeratoplasty Corneal Plaques: A Case Series.

To assess the risk factors and management of corneal plaques formed after keratoplasty. In this retrospective study, medical records of all eyes with plaques formed on top of corneal grafts performed in the period between January 2014 and January 2022 were reviewed. The retrieved data included prekeratoplasty corneal pathology, ocular risk factors, operative data and complications, plaque management, and chemical composition of the plaques using infrared spectrometer. Thirteen eyes were included in this study. Predisposing ocular comorbidities included ocular surface disorders with variable degrees of dry eye in nine patients, rheumatoid arthritis in three patients, history of herpetic keratitis in two eyes, and cicatrizing conjunctivitis in two patients. Surgical excision and amniotic membrane transplantation (AMT) were performed in 12 eyes. Postoperatively, five eyes showed recurrence after excision, two eyes developed graft vascularization and scarring, and one eye showed persistent epithelial defect and graft scarring, whereas four eyes showed complete epithelialization with mild haze. Rekeratoplasty and AMT were performed in two eyes with no plaque recurrence. Chemical analysis using infrared spectrometry showed that the plaques consisted of ammonium magnesium phosphate and calcium phosphate carbonate in 9 (75%) cases and pure mucus in 3 (25%) cases. Postkeratoplasty corneal plaque formation is an underestimated complication of keratoplasty that may occur after persistent epithelial defects. Ocular surface disorders are the primary predisposing risk factors. In our experience, the prognosis after medical treatment or surgical scraping is guarded, and regrafting can be the only solution to restore graft clarity.

Evaluation of the effect of umbilical cord blood serum therapy in resistant infected corneal ulcer

Background Corneal wound healing involves several complex pathways that can be targeted by drugs with varying mechanisms of action. Infected corneal ulcers represent a special challenging situation facing ophthalmologists due to resistance to treatment and visual impairing complications. Purpose The aim of this study was to evaluate the efficacy of umbilical cord blood serum (CBS) as an adjunctive therapy for resistant infected corneal ulcers. Patients and methods This prospective cohort study included 40 eyes having infected corneal ulcer resistant to specific medical treatment for 2 weeks. The patients were recruited from the Cornea Unit at Tanta University Hospital, Tanta, Egypt. They were divided into two groups, 20 cases each. Group A cases were treated with umbilical CBS as an adjunctive therapy together with medical treatment based on culture and sensitivity testing, while group B cases continued the conventional medical treatment only till the complete healing was achieved. The results of the two groups were compared regarding the duration of healing and best-corrected visual acuity improvement. Results Visual acuity improvement was achieved with one or more line gain in 14 (70%) cases in group A compared to 6 (30%) cases in group B, with a statistically significant difference (P = 0.008). Healing was achieved in 16 (80%) cases of group A in 2–4 weeks compared to 14 (70%) cases of group B that achieved healing in a longer duration of 3–6 weeks, with a statistically significant difference (P = 0.001). Amniotic membrane transplantation AMT was required in 4 (20%) cases in group A due to thinning compared to 6 (30%) cases in group B. Conclusion Umbilical CBS was safe and effective when applied to the cornea as an adjunctive therapy in cases of resistant infected corneal ulcers where it accelerated healing with better visual outcome results.

Amniotic Membrane Transplantation for Reconstruction of Ocular Surface Lesion Excisions in Pediatric Population.

To define the use of human amniotic membrane transplantation (hAMT) for reconstruction of the ocular surface after ocular surface lesion excisions in pediatric population during the last decade in a tertiary eye center. A total of 31 patients who underwent hAMT procedure because of the excision of ocular surface lesions between January 2009 and December 2021 were included in this study. The medical data were retrospectively evaluated. The female-to-male ratio was 14/17. The mean age of the patients was 10.1±4.1 (range, 1-18) years. Although a single hAMT was applied to most of the cases (94.4%; 34 eyes), more than one hAMT was applied to 5.6% of cases (2 eyes). The amniotic membrane degradation duration was found to be 21.5±10.8 (range, 13-50) days. Amniotic membrane is used as a biomaterial in various ocular surface diseases with its anti-inflammatory, antimicrobial, and wound healing properties. Although widely used, there are only a few studies reporting its clinical efficacy in the pediatric age group. It seems to be safe and effective in pediatric age group for ocular surface reconstruction after ocular surface lesion excisions.

Amniotic Membrane Transplant: About A Case in Mali

The amniotic membrane graft consists of suturing a fragment of membrane on the de-epithelialized area with a few separate stitches. We report a case of amniotic membrane transplant on keratitis following the local use of a traditional treatment in Mali. It was of a case of amniotic membrane transplant performed in Mali in the management of bilateral keratitis occurring following eyewash with a decoction made from cooked tamarind leaf in a 36-year-old man. We used a 3cm/3cm square AMTRIX® Amniotic Membrane from the Banque de Tissus de France. The membrane was grafted in Patch on the two eyes of our patient, this allowed us to have good healing and improved visual acuity. The use of the amniotic membrane in the management of keratitis gives good functional and anatomical results. She is now possible, However, its availability and cost remains a challenge for our developing countries.

Clinical outcomes of vacuum-dehydrated amniotic membrane (Omnigen) mounted on contact lens (Omnilenz) in eyes with acute chemical eye injuries

BackgroundOmnigen is a vacuum-dehydrated amniotic membrane transplant. It can be delivered to the eye pre-mounted on a special bandage contact lens (Omnilenz) that enables its application without the need for sutures or glue; the aim of this study is to evaluate the short-term clinical outcomes of Omnilenz-Omnigen complex in eyes with acute chemical injury (CEI).MethodsA prospective interventional study included patients with different grades of acute CEI attending the casualty between July 2021 and November 2022. All patients received first aid measures followed by the application of Omnilenz-Omnigen within the first 2 days. Patients were followed up for at least 1 month. Primary outcomes include epithelial defect and limbal ischemia. Secondary outcomes include best-corrected visual acuity (BCVA) and tolerability.ResultsThe study included 23 eyes of 21 patients with acute CEI mostly due to alcohol (34.8%). After the 1st application, the size of the epithelial defect showed a statistically significant reduction (p = 0.016) with improvement in BCVA (p < 0.001). Restoration of the limbal vascularity was obtained in 56.5% of the eyes. Repeated application of Omnilenz was required in 5 eyes (21.7%). The size of the epithelial defect was reduced after the second application (p = 0.504) with improved BCVA (p = 0.185). After 1st month, complete epithelial healing was achieved in all the eyes. Mild limbal ischemia persists in 3 (13%) of the eyes. Final BCVA showed statistically significant improvement (p < 0.001). None of the patients develops any serious complications.ConclusionOmnilenz proved to be easy to apply and well tolerated by patients, with promising clinical outcomes.

Amniotic Membrane Transplantation in the Management of Corneal Ulceration Following Infectious Keratitis

ABSTRACT Purpose To report on the outcomes of amniotic membrane transplantation (AMT) for corneal ulceration following infectious keratitis. Method In this retrospective cohort study of 654 patients with culture-proven infectious keratitis from 8 hospitals in Galicia (Spain), a total of 43 eyes of 43 patients (6.6%) underwent AMT for postinfectious corneal ulceration. The indications for AMT were sterile persistent epithelial defects, severe corneal thinning or perforation. Results AMT was successful in 62.8% of cases, with 37.2% requiring an additional surgery. Median time to healing was 40.0 days (IQR 24.2–101.7 days) and final BCVA was lower than baseline (p = 0.001). Ulcers were large (>3 mm) in 55.8% of cases. Previous herpetic keratitis and topical steroid use were more common in patients who received AMT (p < 0.001). 49 microorganisms (43 bacteria and 6 fungi) were isolated. Conclusions AMT is a therapeutic option for complications following infectious keratitis, which present with a sterile persistent epithelial defect, significant corneal thinning or perforation.

Ectrodactyly-Ectodermal Dysplasia-Cleft Syndrome: Ocular Findings and Surgical Treatment.

Ectrodactyly-ectodermal dysplasia-cleft (EEC) syndrome is a rare genetic disorder. We present ocular findings and their treatment in patients with EEC. We report on 3 female patients (aged 59, 45, and 11 years) suffering from EEC with varying extraocular and ocular severity of phenotypic expression of the disease. Slit-lamp biomicroscopy, visual acuity, and medical treatment were evaluated over 4 months to 4 years. All patients experienced visual impairment and foreign body sensation. Examination revealed bilateral chronic blepharitis, dry eye syndrome, and corneal vascularization and clouding due to limbal stem cell deficiency (LSCD). Patient #1 presented a corneal ulcer with severe stromal thinning on the right eye. Allogeneic simple limbal epithelial transplantation (allo SLET), penetrating keratoplasty combined with allo SLET, and in total 5 amniotic membrane transplantation were performed to preserve the integrity of the eye. In patients #2 and #3, conservative therapy with lubricant eye drops, topical steroids, and antibiotics was sufficient to stabilize LSCD. In all cases, corneal epithelialization and improvement of visual acuity were achieved. To the best of our knowledge, this is the first report of surgical treatment in a patient with EEC. Allo SLET may be a surgical option to treat LSCD associated with EEC.

Comparison between Placement of an Amniotic Membrane Contact Lens and Temporary Amniotic Membrane Transplantation

Purpose: We compared the clinical utilities of an amniotic contact lens and temporary amniotic membrane transplantation in patients with persistent corneal epithelial defects.Methods: Patients diagnosed with persistent corneal epithelial defects from November 2019 to July 2022 were randomly assigned to either lens placement for 2 weeks or temporary transplantation for 1 week, and the outcomes were retrospectively analyzed. The best-corrected visual acuity, corneal sensation, tear film break-up time, and corneal opacity were measured before and after the interventions. The treatment success rates, recurrences, and other complications were analyzed during the follow-up period.Results: We placed lenses in 32 patients (32 eyes) and 20 patients (20 eyes) underwent transplantation. In both groups, significant differences in best-corrected visual acuity, corneal sensation, tear film break-up time, and corneal opacity were apparent after intervention vs. before. None of the parameters showed any significant differences in terms of their rates of change.Conclusions: In patients with persistent corneal epithelial defects, amniotic contact lens placement is an effective outpatient procedure and is not inferior to temporary amniotic membrane transplantation.

Amniotic membrane transplantation: an updated clinical review for the ophthalmologist

Amniotic membrane transplantation: an updated clinical review for the ophthalmologist

The Outcome of Concurrent Intracameral Fluconazole Injection with Amniotic Membrane Transplantation for Fungal Keratitis in Dr. M. Djamil General Hospital: A Case Series

Background: Fungal keratitis is often difficult to eradicate and requires long treatment. Antifungal agents have lower efficacy because of low tissue penetration and the indolent nature of the infection. Fluconazole has effective ocular penetration ability, reaching aqueous concentration as same as plasm concentration. Multilayer amniotic membrane transplantation (MLAMT) has been shown to be a promising surgical procedure to reconstruct the ocular surface by supporting the epithelialization of the cornea and having protective antimicrobial properties. This study aims to report the outcome of concurrent intracameral fluconazole injection with amniotic membrane transplantation for fungal keratitis in Dr. M. Djamil General Hospital.&#x0D; Case presentation: Four inpatients in the ophthalmology ward of Dr. M. Djamil General Hospital with moderate to severe fungal keratitis. All patients were first treated with medications. Because the patients did not show clinical improvement after getting maximum therapy, they underwent intracameral fluconazole injection concurrent with MLAMT. MLAMT was performed with multilayered amniotic membranes to fill and cover the defect. The bandage contact lens was placed to protect and keep the MLAMT in place and for patients’ comfort. Patients were then observed for signs of inflammatory reaction and epithelialization. All patients showed reduced inflammation and improved epithelization after surgery.&#x0D; Conclusion: Concurrent intracameral fluconazole injection with MLAMT can be considered an alternative treatment for refractory fungal keratitis as it decreases the rate of inflammation and improves epithelization.

Clinical Grading of Corneal Ulcer and Its Management in Dr. M. Djamil General Hospital, Padang, Indonesia

Background: Infectious corneal ulcer (CU) occurs due to an agent, which may be a bacterial, fungal, or viral microorganism. A detailed examination of the ulcer was needed to determine the severity grading of the ulcer. Based on the size, depth of ulcer, density of infiltrate, and scleral involvement, it's divided into mild, moderate, and severe grades and may be used to objectively monitor the progress of the ulcer and as a parameter for management. Medical management includes topical, systemic antibiotic, and periocular injection, while amniotic membrane transplantation (AMT), conjunctiva flap, fascia lata, and evisceration as surgical. This study aimed to assess the clinical grading associated with the management of CU in Dr. M. Djamil General Hospital, Padang, Indonesia.&#x0D; Methods: Observational analytics based on the medical record of corneal ulcer patients in Dr. M. Djamil General Hospital, Padang, Indonesia, in 2016-2017. A total of 191 research subjects participated in this study. Data analysis was carried out using SPSS univariately.&#x0D; Results: The fungal, bacterial, and viral CU was diagnosed clinically. The severity grading that we found is moderate (60,73%), mild (25,14%), and severe (14,13%). All of the cases used medical treatment. Surgical was performed in moderate (36,59%) and all severe cases. AMT was performed in severe cases with perforation ≤ 4 mm and perforation &gt; 4 mm conjunctival flap (3.7%), fascia lata (3,7%), and evisceration (61,53%), preferably.&#x0D; Conclusion: The clinical grading of corneal ulcers in our hospital is moderate, and it may be associated with our hospital as a referral hospital. Surgery was performed in all severe and moderate cases that don't respond well to medicine.

Ophthalmic Aspects of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Narrative Review.

The aim of our review article was to summarize the current literature on Stevens-Johnson syndrome (SJS) and its severe form, toxic epidermal necrolysis (TEN). SJS/TEN is a serious, rare multi-system, immune-mediated, mucocutaneous disease with a significant mortality rate that can lead to severe ocular surface sequelae and even to bilateral blindness. Restoration of the ocular surface in acute and chronic SJS/TEN is challenging. There are only limited local or systemic treatment options for SJS/TEN. Early diagnosis, timely amniotic membrane transplantation and aggressive topical management in acute SJS/TEN are necessary to prevent long-term, chronic ocular complications. Although the primary aim of acute care is to save the life of the patient, ophthalmologists should regularly examine patients already in the acute phase, which should also be followed by systematic ophthalmic examination in the chronic phase. Herein, we summarize actual knowledge on the epidemiology, aetiology, pathology, clinical appearance and treatment of SJS/TEN.

Bleb analysis using anterior segment optical coherence tomography after trabeculectomy with amniotic membrane transplantation.

Little has been known about the intrableb structures associated with bleb function after trabeculectomy with amniotic membrane transplantation (AMT). The aim of this study is to analyze the characteristics of intrableb structures using anterior segment optical coherence tomography (AS-OCT) after trabeculectomy with AMT. A total of 68 eyes of 68 patients with primary open-angle glaucoma who underwent trabeculectomy with AMT were included. Surgical success was defined as intraocular pressure (IOP) ≤ 18 mmHg and IOP reduction of ≥ 20% without medication on AS-OCT examination. Intrableb parameters, including bleb height, bleb wall thickness, striping layer thickness, bleb wall reflectivity, fluid-filled space score, fluid-filled space height, and microcyst formation were evaluated using AS-OCT. Logistic regression analysis was performed to determine factors associated with IOP control. Of the 68 eyes, 56 eyes were assigned to the success group and 12 eyes to the failure group. In the success group, bleb height (P = 0.009), bleb wall thickness (P = 0.001), striping layer thickness (P = 0.001), fluid-filled space score (P = 0.001), and frequency of microcyst formation (P = 0.001) were greater than those in the failure group. Bleb wall reflectivity was higher in the failure group than in the success group (P < 0.001). In the univariate logistic regression analysis, previous cataract surgery was significantly associated with surgical failure (odds ratio = 5.769, P = 0.032). A posteriorly extending fluid-filled space, tall bleb with low reflectivity, and thick striping layer were characteristics of successful filtering blebs after trabeculectomy with AMT.

Morphology of pterygium

This article details the morphology of pterygium, eastern regional eye care program in eastern Nepal, surgical steps for pterygium removal, amniotic membrane transplantation, procedure pterygium excision with conjunctival autograft.

Bacterial Keratitis. Part 2. Topical Aspects of Treatment

Bacterial keratitis (BC) is a threatening condition for the anatomy and function of the eyeball and requires an immediate complex of therapeutic measures. Effective treatment that preserves the anatomical and functional result of the organ of vision, including various non-surgical and surgical methods, is the basis for the treatment of CD. Drug therapy includes, first of all, massive etiotropic therapy, which is usually represented by broad-spectrum antibiotics, antiseptics and anti-inflammatory drugs. These combinations make it possible to competitively influence all links of the pathological process, showing an additive effect. Promising non-surgical means in the fight against bacterial infection of the cornea, in particular with resistant microorganisms, is the use of Quantum dots, Mitomycin C, Matrix metalloproteinases. The most radical surgical methods of treatment are based on therapeutic keratoplasty, the purpose of which is to excise the infectious focus of the cornea and restore its transparency through transplantation of donor corneal tissue, but this method has a number of disadvantages and limitations in its implementation. Autoconjunctival keratoplasty is the oldest method of treatment of progressive corneal ulcers and this method should be considered rather as temporary or preparatory before through keratoplasty, due to the lack of visual functions. The least radical and relevant surgical methods of CD treatment today are the use of Corneal Crosslinking, Microdiathermocoagulation, Cyanoacrylate glue, Amniotic membrane transplantation. The expansion of the arsenal of methods of influencing the microbial process of the cornea and their further study will allow for a quick response in response to the rapidly developing antibiotic resistance in the world.

Clinical Approach to Ocular Cicatricial Pemphigoid.

To evaluate the demographic data, ocular and systemic findings, clinical management, and outcomes of patients with ocular cicatricial pemphigoid (OCP). The medical records of 11 patients diagnosed as having OCP in the ophthalmology department of Ege University between 2008 and 2021 were evaluated retrospectively. The patients' mean follow-up time was 14±5.76 months. All eyes (100%) had conjunctival involvement and 18 (81.81%) had corneal involvement. According to the Tauber staging system, 7 (31.81%), 8 (36.36%), and 7 (31.81%) of the eyes were stage 2, 3, and 4, respectively. The diagnosis was confirmed in 6 (66.66%) of 9 patients who underwent biopsy. Amniotic membrane transplantation was performed in 7 eyes, entropion surgery in 2 eyes, and electrocauterization for trichiasis in 5 eyes. Systemic involvement was observed in 45.45% (5/11) of patients, most commonly oral mucosal involvement (18.18%). Review of medical records showed that alkylating agents, steroids, and dapsone were used in patients treated before 2020. Mycophenolate mofetil was preferred to be used in combination with corticosteroids. Although treatment responses before mycophenolate mofetil usage could not be evaluated well because of loss to follow-up, 4 (66.66%) of 6 patients who received steroid treatment combined with mycophenolate mofetil showed partial or complete clinical remission. No serious side effects and drug withdrawal were observed. OCP is a sight-threatening autoimmune disease that affects older adults. Although positive biopsy results are valuable for diagnosis, negative results do not exclude the diagnosis. The main treatment is systemic immunosuppressives. Disease activity can be suppressed, especially with early initiation of drug therapy. These patients require a multidisciplinary approach. Especially in the presence of isolated ocular findings, ophthalmologists should be able to make the decision to start immunosuppressive treatment, and systemic treatment should not be delayed.

MANIFESTASI KLINIS DAN TATALAKSANA OPERATIF DEGENERASI KORNEA NODULAR SALZMANN

Introduction : Salzmann nodular degeneration (SND) is an idiopathic and degenerative noninflammatory condition of the cornea. SND is characterized by a grayish-white or blue-white subepithelial nodule. Mild symptoms may improve with lubrication and topical anti-inflammatory therapy. Visual disturbances may occur and surgery may be required. Purpose: To explain clinical manifestations and operative management of corneal Salzmann nodular degeneration. Case Report: A 63-year-old woman came with the chief complaint of a nodule in her left eye since 4 months ago. Complaints accompanied by blurry vision, watery eyes and glare. Ophthalmological examination revealed a regression of visual, a nodule in the corneal stroma was grayish white. After examination, the patient was diagnosed with Salzmann OS nodular degeneration and ODS immature senile cataract. Debridement keratectomy and amniotic membrane transplantation (AMT) were performed as the management of this patient. Anatomical pathology results clinically support Salzmann's nodular degeneration. Discussion: Slow-progressive, yellowish-white nodules are characteristic of SND. SND can be asymptomatic, mild symptoms, or until there is a decrease in visual function. It depends on the location and depth of the nodule. Several treatment options can be done ranging from conservative with topical drugs to surgery. Surgical treatment options have the goal of reducing the worsening symptoms of nodule recurrence. Conclusions: A complete history, comprehensive ophthalmological examination can help establish the diagnosis of SND. The appearance of nodules causes complaints of foreign body sensation, decreased visual function and other accompanying symptoms. Treatment needs to be given according to the patient's condition and indications, especially the selection of surgical therapy.

Sutureless Amniotic Membrane Transplantation Using Pediatric Nasogastric Tube for Patients With Acute Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.

Evaluation of the results of sutureless amniotic membrane transplantation (AMT) using a pediatric nasogastric tube (NGT) for patients with acute Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) was aimed. Twenty-six eyes of 13 patients with SJS/TEN with ocular involvement at a single tertiary care hospital between May 2020 and January 2022 were included in the study. An amniotic membrane was implanted to the ocular surface and conjunctival fornix using a modified symblepharon ring (MR) created by inserting NGT end-to-end. Patients were followed for at least 6 months. The mean duration of the surgery was recorded. The presence of corneal epithelial defect and vascularization, meibomian gland dysfunction (MGD) grade, conjunctival scarring, eyelid margin keratinization, symblepharon, and trichiasis were recorded. The mean age of the patients was 38.4±17.6 years. Amniotic membrane transplantation was performed only once for eight patients and twice for five patients. The mean duration of the surgery was 3.2±0.4 min. The modified symblepharon ring was removed 28 days after its application. At the first examination, 20 eyes (76.9%) had a corneal epithelial defect and 6 (23.1%) had early symblepharon. At the postoperative 6 months, although seven eyes (26.9%) had conjunctival scarring and 5 (19.2%) had eyelid margin keratinization, all patients were without any corneal defect, corneal vascularization, or symblepharon. Only 11 eyes (42.3%) showed MGD, and 1 eye (3.8%) showed trichiasis. This study showed that sutureless AMT using pediatric NGT could be a potentially fast and inexpensive treatment option for the treatment of SJS/TEN with ocular involvement at the bedside without the need for general anesthesia.

Personalized 3D-printed amniotic fornical ring for ocular surface reconstruction.

In the present work, we used three-dimensional (3D) printing technology to make a polylactic acid (PLA) amniotic fornical ring (AFR) for ocular surface reconstruction. This work is a retrospective and interventional case series of patients with ocular surface diseases who underwent either personalized 3D-printed AFR-assisted amniotic membrane transplantation (AMT) or sutured AMT (SAMT). Patient epidemiology, treatment, operative duration, epithelial healing time, retention time, vision changes, morbidity, and costs were analyzed. Thirty-one patients (40 eyes) and 19 patients (22 eyes) were enrolled in the 3D-printed AFR group and the SAMT group, respectively. The clinical indications of AFR and SAMT were similar, such as corneal and/or conjunctival epithelial defects due to chemical burns, thermal burns, Stevens-Johnson syndrome (SJS), or toxic epidermal necrolysis (TEN). The mean dissolution time was 15 ± 11 days in the AFR group, compared with 14 ± 7 days in the SAMT group. The percentage of healed corneal area was 90.91% (66.10%-100.00%) for AFR and 93.67% (60.23%-100.00%) for SAMT. The median time for corneal epithelial healing was 14 (7-75) days in the AFR group and 30 (14-55) days in the suture AMT group. There were no significant differences in the initial visual acuity, final visual acuity, or improvement in visual acuity between the two groups. The operation duration in the AFR group was significantly shorter than that in the SAMT group. Regarding the cost analysis, the average cost per eye in the AFR group was significantly lower than that in the SAMT group. Furthermore, 3D-printed and sterile AFR showed no obvious side effects on the eyes. Our results suggested that 3D-printed PLA scaffolds could be used as an AFR device for ocular surface disease. In addition, personalized 3D-printed AFR is superior to conventional AMT in operation duration and cost effectiveness, thereby reducing the financial burden on our health care system.