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A controlled study of amniotic membrane transplantation for acute Pseudomonas keratitis
Ahmad Kheirkhah1, Ali Tabatabaei, Mehdi Khodaparast Zavareh
1Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. akheirkh@yahoo.com
Objective:
To evaluate the efficacy of amniotic membrane transplantation (AMT) to improve the outcomes of acute Pseudomonas keratitis as compared with a control group.
Design:
Prospective interventional case series with retrospective controls.
Participants:
We studied 14 eyes with Pseudomonas keratitis as the AMT group and 11 eyes with Pseudomonas keratitis as the control group.
Methods:
Eyes in the AMT group were treated with antibiotic therapy followed by single-layer AMT at 2 to 3 days. Eyes in the control group received only antibiotic therapy. Patients were followed for 11.1 ± 2.4 months.
Results:
In the AMT group, pain significantly decreased from a mean score of 2.4 ± 0.5 preoperatively to 1.1 ± 0.9 at day 2 postoperatively (p < 0.001). Corneal epithelial defects healed completely within 13.2 ± 2.6 days in the AMT group compared with 15.5 ± 3.4 days in the control group (p = 0.07). At final follow-up visits, the sizes of corneal opacity and deep neovascularization were not different between the 2 groups. However, the mean score for density of the corneal opacity was significantly less in the AMT group compared with the control group (2.1 ± 0.4 vs 2.5 ± 0.7, respectively, p = 0.04). Although the best corrected visual acuity using hard contact lenses was not different between the 2 groups, uncorrected visual acuity was better in the AMT group (0.45 ± 0.22 logMAR) than in the control group (0.71 ± 0.32 logMAR, p = 0.03). No patient in either group developed significant corneal thinning or perforation.
Conclusions:
AMT in acute Pseudomonas keratitis was associated with immediate pain relief, less density of the final corneal opacity, and better uncorrected visual acuity at the final follow-up visit.
Insights
Amniotic membrane transplantation (AMT) for Pseudomonas keratitis offers rapid pain relief and improved uncorrected vision. This treatment also reduces the density of corneal opacity, aiding recovery.
Area of Science:
- Ophthalmology
- Corneal Disease
- Regenerative Medicine
Background:
- Acute Pseudomonas keratitis is a severe microbial infection of the cornea.
- Prompt and effective treatment is crucial to prevent vision loss and complications.
- Amniotic membrane transplantation (AMT) is explored as an adjunctive therapy.
Purpose of the Study:
- To assess the efficacy of amniotic membrane transplantation (AMT) in managing acute Pseudomonas keratitis.
- To compare outcomes in patients treated with AMT plus antibiotics versus antibiotics alone.
Main Methods:
- A prospective interventional case series with retrospective controls was conducted.
- 14 eyes with Pseudomonas keratitis received antibiotic therapy followed by AMT.
- 11 eyes with Pseudomonas keratitis received antibiotic therapy only (control group).
Main Results:
- The AMT group showed significant pain reduction within 2 days post-transplantation.
- Corneal epithelial healing occurred within 13.2 days in the AMT group versus 15.5 days in controls.
- The AMT group had significantly less dense corneal opacity and better uncorrected visual acuity at final follow-up.
Conclusions:
- Amniotic membrane transplantation is effective in managing acute Pseudomonas keratitis.
- AMT provides rapid pain relief and improves visual outcomes.
- This therapy leads to reduced corneal opacity density.
