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Published on: September 12, 2014
Amniotic Membrane Transplantation in the Management of Corneal Ulceration Following Infectious Keratitis
David Lamas-Francis1, Daniel Navarro2, Claudio Moreno3
1Department of Ophthalmology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Purpose:
To report on the outcomes of amniotic membrane transplantation (AMT) for corneal ulceration following infectious keratitis.
Method:
In this retrospective cohort study of 654 patients with culture-proven infectious keratitis from 8 hospitals in Galicia (Spain), a total of 43 eyes of 43 patients (6.6%) underwent AMT for postinfectious corneal ulceration. The indications for AMT were sterile persistent epithelial defects, severe corneal thinning or perforation.
Results:
AMT was successful in 62.8% of cases, with 37.2% requiring an additional surgery. Median time to healing was 40.0 days (IQR 24.2-101.7 days) and final BCVA was lower than baseline (p = 0.001). Ulcers were large (>3 mm) in 55.8% of cases. Previous herpetic keratitis and topical steroid use were more common in patients who received AMT (p < 0.001). 49 microorganisms (43 bacteria and 6 fungi) were isolated.
Conclusions:
AMT is a therapeutic option for complications following infectious keratitis, which present with a sterile persistent epithelial defect, significant corneal thinning or perforation.
