Effect of Amniotic Membrane Transplantation on Corneal Ulcers Due to Infectious Keratitis: A Retrospective Analysis

This study evaluates the effectiveness of cryopreserved human amniotic membrane transplantation (hAMT) in treating infectious keratitis (IK)-related corneal ulcers and perforations and identifies prognostic factors affecting outcomes.

A retrospective analysis was conducted on 36 eyes of 36 patients treated with hAMT for IK-induced corneal ulcer or perforation. Demographic and clinical data were reviewed to assess treatment efficacy and outcome predictors. Treatment success was defined as complete re-epithelialization within 3 months post-intervention, while failure included persistent defects, phthisis bulbi, or need for emergency keratoplasty.

The mean age was 66.69 ± 14.53 years; 58.3% were male. At presentation, 41.7% had corneal perforation, and 58.3% had corneal thinning without perforation. Corneal cultures were positive in 38.8% of cases (12 bacterial, 4 fungal, 5 polymicrobial). The average time from diagnosis to hAMT was 5 days. The mean epithelial healing time for all eyes was 21.66 ± 12.59 days, with no significant difference between perforated and non-perforated eye groups (p = 0.053). Repeated hAMT was needed in 46.7% of perforated and 19% of non-perforated eyes. Initial success was 66.7%, higher in non-perforated (81%) compared to perforated eyes (53.3%). Final best-corrected visual acuity (BCVA) remained stable in 55.6%, decreased in 2.8% and improved in 41.7% of patients, with no significant group difference (p = 0.851). Overall treatment success was 94.4%, with two failures.

hAMT is an effective and safe option for managing IK-related corneal ulcers and perforations. It supports epithelial healing and maintains ocular integrity, especially when infection is adequately controlled.