Amniotic membrane transplantation for acute ocular burns

Area of Science:

• Ophthalmology
• Regenerative Medicine
• Stem Cell Biology

Background:

• Ocular surface burns damage limbal stem cells, leading to delayed healing and potential vision loss.
• Amniotic membrane transplantation (AMT) is a surgical intervention applied in the acute phase of burns to promote healing.
• The efficacy of AMT for different severities of ocular burns remains debated.

Purpose of the Study:

• To evaluate the effectiveness of AMT compared to medical therapy alone for acute ocular surface burns.
• To assess the impact of AMT on re-epithelialisation, visual acuity, and other key outcomes.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches.
• Included trials compared AMT plus medical therapy versus medical therapy alone within seven days of injury.
• Outcomes included re-epithelialisation failure, visual acuity, corneal neovascularisation, symblepharon, and time to healing.

Main Results:

• For moderate burns, AMT showed a possible benefit in reducing re-epithelialisation failure and improving visual acuity, though evidence was of very low to low certainty.
• For severe burns, AMT demonstrated no significant benefit in preventing re-epithelialisation failure or improving visual acuity.
• Evidence for other outcomes like neovascularisation and symblepharon was inconclusive for both burn severities due to wide confidence intervals and risk of bias.

Conclusions:

• Current evidence is uncertain regarding the benefits of AMT for moderate acute ocular surface burns.
• AMT does not appear to offer significant advantages for severe ocular burns.
• High risks of bias and imprecision limit definitive conclusions on AMT's efficacy in ocular burn management.