Amniotic membrane transplantation for acute ocular burns

Area of Science:

• Ophthalmology
• Regenerative Medicine
• Trauma Care

Background:

• Ocular surface burns, caused by chemicals or heat, pose significant risks to vision.
• Amniotic membrane transplantation (AMT) is a surgical procedure involving applying amniotic membrane (AM) to the ocular surface.
• AMT is proposed to aid healing and reduce complications in acute ocular surface burns.

Purpose of the Study:

• To evaluate the efficacy of amniotic membrane transplantation (AMT) in treating acute ocular surface burns.
• To assess the impact of AMT on epithelialization and visual acuity following burns.

Main Methods:

• A systematic search of multiple databases (CENTRAL, MEDLINE, EMBASE, LILACS, mRCT, ClinicalTrials.gov, ICTRP) was conducted.
• Included were randomized controlled trials comparing AMT plus medical therapy versus medical therapy alone for ocular surface burns within seven days of injury.
• Data were extracted and analyzed using risk ratios and mean differences, with independent assessment of study bias.

Main Results:

• One randomized controlled trial with 100 participants was included, analyzing a subset of 68 patients with moderate to severe ocular burns.
• In moderate burns, AMT showed a trend towards improved epithelialization (RR 0.18, P=0.09) and significantly better final visual acuity (MD -0.32).
• In severe burns, AMT showed no significant difference in epithelialization (RR 1.01) or final visual acuity (MD 0.13), with high risks of bias identified in the study.

Conclusions:

• Conclusive evidence supporting amniotic membrane transplantation (AMT) for acute ocular surface burns is currently insufficient.
• Factors such as disease heterogeneity, treatment variations, and outcome measure inconsistencies complicate definitive conclusions.
• High risks of bias in the included study limit confidence in the findings, necessitating further high-quality research.