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Published on: September 12, 2014
Management of Persistent Corneal Epithelial Defects with Human Amniotic Membrane-derived Dry Matrix
Sundas Maqsood1,2, Kareem Elsawah3, Navpreet Dhillon1
1Corneo-Plastic Unit, Queen Victoria Hospital NHS, East Grinstead, UK.
Objective:
To report the outcomes of using human amniotic membrane-derived dry matrix (AMDDM) in the management of persistent corneal epithelial defects (PEDs) of various etiologies.
Methods:
A cohort study of 84 patients age range 7 to 92 years with 93 PEDs were treated with AMDDM (Omnigen® using OmniLenz® at two centers (Queen Victoria Hospital and Maidstone Hospital) in the UK. The main outcome measures were healing response of PED and time to heal after application of AMDDM.
Results:
A total of 106 applications of AMDDM were recorded for 81 patients (52 males, 29 females) with a spectrum of different etiologies. Fifty-eight percent of the eyes showed complete healing, and 28% showed partial decrease of the size of PEDs with average treatment length recorded as 22.4±12.3 days. In patients with limbal stem cell deficiency (n=44; aniridia=12, chemical injury=9, Stevens-Johnson syndrome=10), 50% of PEDs showed complete healing and 27% showed partial healing. In patients with microbial keratitis (n=21) (bacterial: 13, fungal: 4, herpetic: 3, acanthamoeba: 1) 57% of PEDs showed complete healing and 33% were partially healed. In patients with keratoplasty (n=16), 56% of PEDs showed complete healing and 31% were partially healed. Vision remained stable in 59% and improved in 27% of the study the population.
Conclusion:
AMDDM can be easily applied in the clinical setting and has demonstrated its efficiency as a new tool to treat persistent epithelial defects.
Insights
Human amniotic membrane-derived dry matrix (AMDDM) effectively treats persistent epithelial defects (PEDs), showing significant healing rates across various causes. This novel approach offers a promising new tool for corneal regeneration and improved visual outcomes.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Biomaterials Science
Background:
- Persistent epithelial defects (PEDs) pose a significant challenge in ophthalmology, often leading to vision loss.
- Current treatments for PEDs have variable success rates and can be invasive.
- Human amniotic membrane-derived dry matrix (AMDDM) presents a potential novel therapeutic option.
Purpose of the Study:
- To evaluate the clinical outcomes of using AMDDM for managing PEDs of diverse etiologies.
- To assess the healing response and time to heal in patients treated with AMDDM.
- To determine the efficacy of AMDDM in different patient subgroups, including those with limbal stem cell deficiency, microbial keratitis, and post-keratoplasty.
Main Methods:
- A cohort study involving 84 patients (93 PEDs) treated with AMDDM (Omnigen® using OmniLenz®) across two UK centers.
- Data collected on healing response, time to heal, and visual outcomes.
- Analysis of outcomes based on the etiology of PEDs, including limbal stem cell deficiency, microbial keratitis, and post-keratoplasty.
Main Results:
- Overall, 58% of PEDs showed complete healing, and 28% showed partial healing, with an average treatment duration of 22.4 days.
- In limbal stem cell deficiency cases, 50% achieved complete healing and 27% partial healing.
- Effective healing rates were also observed in patients with microbial keratitis (57% complete, 33% partial) and post-keratoplasty (56% complete, 31% partial).
- Visual acuity remained stable in 59% and improved in 27% of patients.
Conclusions:
- AMDDM is a readily applicable clinical tool for managing persistent epithelial defects.
- The study demonstrates the efficacy of AMDDM in promoting healing across a spectrum of PED etiologies.
- AMDDM represents a promising new therapeutic option for improving outcomes in patients with challenging corneal conditions.
