Amniotic Membrane Inlay and Overlay Grafting for Corneal Epithelial Defects and Stromal Ulcers

Abstract

Objectives:To determine the effect of amniotic membrane transplantation (AMT) on persistent corneal epithelial defects (PEDs) and to compare the efficacy between inlay and overlay techniques.Methods: Thirty patients (30 eyes) underwent AMT for PED. The use of AMT was restricted to patients in whom all previous measures, including bandage contact lens and tarsorrhaphy, had failed. The amniotic membrane was placed on the surface of the cornea in overlay (group A) or inlay (group B) fashion.

Corneal sensitivity and ocular surface changes following preserved amniotic membrane transplantation for nonhealing corneal ulcers

“…We observed that AMT could improve visual acuity, probably owing to both corneal surface restoration and improvement of corneal transparency. 23 However, the visual results in our patients also suggest that the effect of AMT on visual rehabilitation is limited. A donor cornea may be the most suitable material for grafting to treat a nonhealing ulcer and to achieve visual rehabilitation.…”

“…In our experience, AMT could effectively heal the ulcers similar to other reports. [21][22][23][24][25][26] The healing was with corneal epithelial phenotype in six eyes. Three eyes healed by conjunctival epithelial phenotype which can be explained by the difference in the cause of the epithelial defects, associated problems and the previous treatments, and thus by the extent of initial damage to the ocular surface.…”

Amniotic membrane transplantation for persistent corneal epithelial defects in eyes after penetrating keratoplasty

“…The recurrence rate was higher (44%) in our study as compared to previous studies. 15,18,29 This may be due to multiple risk factors in the presented eyes after PK. Although AMT can treat the current pathology, primary neurotrophic components will still persist since adequate LSCs and intact sensory innervation is mandatory for repairing and maintaining ocular surface integrity.…”

“…14 Another proposed mechanism through which AM facilitates epithelialization might be its function as a bandage contact lens protecting the migrating epithelial cells from the shearing movements of the eyelids. 15,16 AM is also effective in preventing excessive fibrosis during ocular surface reconstruction. 17 It acts as a physical barrier, protecting the corneal stroma from damaging inflammatory cells and proteins in the tear film.…”

Amniotic membrane in ophthalmology: indications and limitations

“…18 However, the early detachment of the membrane despite diligent suturing remains a limiting factor with its use. 19 Su and Lin 20 have described the use of the AM to successfully seal corneal perforations. Fibrin or cyanoacrylate glue application are other effective alternative means of sealing perforations.…”