Multilayer amniotic membrane transplantaion for treatment of perforated corneal ulcerations

ABSTRACT

To examine the efficacy of amniotic membrane transplantation [AMI] in the treatment of perforated corneal ulcerations. Eighteen patients [18 eyes] with perforated corneal ulcers were treated with multilayered AMT. Separate amniotic membranes [AM] were transplanted as material to fill the stromal layer [AM filling], as a basement membrane [AM graft], and as a wound cover [AM patch]. The underlying causes of corneal perforation included herpes simples keratitis [6 eyes], mixed bacterial and fungal keratitis [4 eyes], bacterial keratitis [3 eyes], bullous keratopathy [3 eyes], and Moor en's ulcer [2 eyes]. During the follow up period of 16.7 +/- 7.2 months [8 - 21 months] after AMT, 13 [72.2%] of 18 eyes healed with a mean 27.2 +/- 9 epithelialization period of 18.3 +/- 6 days [range 11 to 32 days]. The remaining 5 eyes [27.8%] received second AMT, but disentgration of the amniotic membrane [AM] occurred and they received conjuntival flap. No patient developed major postoperative complications or graft rejection. Multilayer amniotic membrane transplantation can he used as an emergency treatment for perforated corneal ulcerations to restore corneal integrity so that emergency penetrating keratoplasty [PK] can be avoided