Results of Resorbable and Running Sutured Amniotic Multilayers in Sterile Deep Corneal Ulcers and Perforations

To present the results of a modified surgical technique for secure tightening and fixation of multilayer amniotic membranes (AMs) in sterile deep or perforating corneal ulcers.

We retrospectively analyzed the data of patients suffering from corneal ulcers who had been treated between February 2016 and June 2018 with running and resorbable sutures to fixate multilayer AMs. The parameters analyzed were gender, age, etiology of corneal ulcer, ulcer diameter, corneal thickness (CST) before and after the microsurgical procedure as measured with optical coherence tomography, number of inlays, repeat surgical procedures, follow-up duration in months, and rate of success (defined as a stable anterior chamber with improved CST, a negative Seidel test, and no need for any microsurgical keratoplasty during the first 6 months after treatment). The results were statistically evaluated using the Wilcoxon test. A P-value ≤0.05 was considered to show a statistically significant difference.

The CST increased significantly after AM transplantation (from 206.26 ± 114.93 μm at baseline to 454.70 ± 244.08 μm at 1-3 months; P < 0.001). Repeat multilayer transplantation was required in 7 of the 23 patients included (30.4%), in 6 of whom the treated eye was stable at month 6. In 2 of the 23 patients, perforating keratoplasty became necessary. One patient also demanded such a procedure to improve his visual acuity. The success rate was 91.3% (n = 21).

Running resorbable suture fixation of multilayer AMs proved to be an efficient means for the treatment of noninfectious deep or small perforating corneal ulcers.