Impact of Adjuvant Amniotic Membran Transplantation In Infectious Ulcerative Keratitis

Abstract

PURPOSE: To evaluate the impact of adjuvant human amniotic membrane transplantation(hAMT) in patients with infectious ulcerative keratitis on wound healing without waiting for the sterile phase of the infectious keratitis.METHODS: A retrospective cohort study based on medical records of patients who underwent hAMT procedure over a 2-year period (2020-2021) was conducted at Ege University Hospital, Turkey. Cryopreserved hAM was used. Best corrected visual acuity (BCVA) was measured with the Snellen chart. Detailed ophthalmological examination was performed at all visits. Treatment success was defined as complete healing including disappearance of corneal infiltrates, epithelial defect closure, reduction of anterior segment reaction.RESULTS: A total of 13 eyes of 12 patients who were diagnosed with ulcerative keratitis between 2020-2021. The mean age was 60.9 years and 66.6% of the patients were male. Average ulcer horizontal diameter was 9.7 (4.5–12) mm. A single layer human amniotic membrane (hAM) was transplanted 92.3% of eyes. Overlay technique was used in all patients for hAMT. The mean residence time of the amniotic membrane on the ocular surface was 13.3 (5-40) days. The mean time from the first presentation to the hAM transplantation was 9.8 (3-30) days. The average hospitalization time of all patients was 15 (3-46) days, pre- hAMT was 10.2 days and post hAMT was 4.8 days. The mean follow up time was 3 months. Recovery response was positive in 76.9%. Average healing time was 32.1 (6-57) days. CONCLUSIONS: hAMT was effective in the treatment of infectious ulcerative keratitis by accelerating wound healing and supporting the ocular surface biochemically and mechanically. Performing hAM transplantation at the early stages of the disease and prolonged residence of membrane on the ocular surface increase the success of the treatment and moreover abbreviates hospitalization time.