Efficacy of Amniotic Membrane Transplantation in Infectious Corneal Perforations of Various Sizes

Thatte S and Singh OS

Published on: 2021-02-19

Abstract

Aim: To evaluate the efficacy of Amniotic membrane transplantation in infectious corneal perforations of various sizes.

Purpose: To determine if single / multilayer amniotic membrane transplantation (AMT) is beneficial in the management of infective corneal perforations, particularly to assess effectivity with various sizes of perforation and its limitations.

Material: 62 eyes of 62 patients with refractory infective keratitis with corneal perforations of various sizes were examined and grouped according to the size of perforation. These underwent single or multilayer amniotic membrane transplantation as per size of perforation. Minimum follow-up was up to 6 months. Success of AMT was supervised to observe improvement in infection, inflammation and healing of perforation.

Result: Acceptable response was seen in smaller perforation less than 2mm with single layer and 2 to 6 mm of perforations with multilayer AMT. Satisfactory results were seen in 75.8%, intermediate results in 24.2%, requiring minor subsequent secondary procedure. Desired tectonic result with complete healing of corneal perforation was seen in 92.85% , but optical results with visual gain was attained only in 71.4% patients , rest 21.4% cases show no visual gain as these cases healed with central leucomatous corneal opacity obscuring the visual axis , requiring subsequent optical penetrating keratoplasty.

Conclusion: AMT is advantageous to resolve tissue degradation, enduring inflammation and for restoration of perforated corneal surface in infectious corneal perforations. Less than 2mm to 6 mm size of perforations attains complete healing. Where as in more than 6 mm of perforation, Amniotic membrane is a useful as a temporary tool to maintain integrity of eyeball.