Related Experiment Video
Updated: Aug 7, 2026
Combination of Microstereolithography and Electrospinning to Produce Membranes Equipped with Niches for Corneal Regeneration
Published on: September 12, 2014
Amniotic membrane transplantation for persistent corneal ulcers and perforations in acute fungal keratitis
Hung-Chi Chen1, Hsin-Yuan Tan, Ching-Hsi Hsiao
1Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Purpose:
To report the therapeutic effect and complications of amniotic membrane transplantation (AMT) in acute fungal keratitis.
Methods:
Diagnosis of fungal keratitis was confirmed by cultures in 23 eyes of 23 patients. The indications to perform AMT were to promote reepithelialization in non-healing ulcers or to prevent corneal perforation. Antifungal agents were administered throughout the whole course of hospitalization. Repeated cultures were performed immediately before AMT. The main outcome measurements were epithelial healing rate, necessity of therapeutic penetrating keratoplasty (TPK), and persistence of infection.
Results:
During a mean follow-up time of 20.6 months +/- 23.22 (6-65 months) AMT was performed during the active phase of the keratitis (fungal culture was still positive) in 16 patients (69.6%), and during the inactive phase (fungal culture negative) in 7 patients (30.4%). Single-layer AMT was performed in 17 patients, and double-layer AMT was performed in 6 patients with corneal perforation and anterior chamber collapse. Complete epithelialization was observed in 12 patients (75%) in the active group and in 7 patients (100%) in the inactive group. Treatment failure requiring TPK was experienced in 4 patients (25%) in the active group. Persistent fungal keratitis was noted in 2 patients (8.7%) in that group. The final visual acuity improved in 17 cases, worsened in 2 cases, and remained unchanged in 4 cases. Twelve of the 23 eyes (52.2%) in this study preserved useful vision (20/400 and better) with or without subsequent surgeries.
Conclusion:
AMT is effective in promoting epithelialization and preventing corneal perforations in acute fungal keratitis, and there is no risk of rejection. However, the risk of persistent or recurrent infection necessitates continued antifungal treatment and patient monitoring.
Insights
Amniotic membrane transplantation (AMT) effectively promotes healing and prevents perforation in fungal keratitis. Continued antifungal treatment is crucial to manage persistent or recurrent infections after AMT.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Acute fungal keratitis presents a significant challenge to ocular health, often leading to vision loss.
- Amniotic membrane transplantation (AMT) is explored as a therapeutic adjunct for severe cases.
Observation:
- This study evaluated 23 patients with fungal keratitis undergoing AMT.
- AMT was performed during active infection in 16 patients and inactive infection in 7.
- Epithelialization rates were high (75% active, 100% inactive), but 25% of active cases required therapeutic penetrating keratoplasty.
Findings:
- AMT significantly promoted epithelial healing in fungal keratitis, with higher success in inactive phases.
- Corneal perforation was prevented in some cases, but persistent infection occurred in 8.7% of patients.
- Over half of the eyes (52.2%) achieved useful vision post-treatment.
Implications:
- AMT is a valuable tool for managing fungal keratitis, aiding epithelial repair and preventing perforation.
- Close monitoring and continued antifungal therapy are essential to mitigate risks of persistent or recurrent fungal infections.
- AMT offers a viable option with no rejection risk, improving visual outcomes in select fungal keratitis patients.
