PURPOSE: To determine the primary success and recurrence rate of amniotic membrane transplantation (AMT) for the treatment of persistent corneal epithelial defects (PEDs) in eyes after penetrating keratoplasty (PK). DESIGN: Retrospective, non-randomized, observational case series. METHOD: AMT was performed in 24 eyes of 24 patients with erosions (n=6) or ulcers (n=18), which were resistant to medical therapy. All eyes had undergone one (42%) or more PKs before AMT. After the removal of epithelium and pannus (if present), one or more layers of AM ('graft' (n=3), 'patch' (n=5), 'sandwich'=combination of graft/patch (n=16)) were transplanted. Main outcome measures included 'surgical success' (epithelium closed within 4 weeks after AMT), and 'recurrence' (new epithelial defect developing during follow-up after surgical success). RESULTS: The rate of surgical success was 70% and was found to be inversely proportional to the number of previous PKs. Defects limited only to the centre of the graft had a higher success rate (central: 100%, non-central: 61%). A total of 44% successful eyes (erosions: 75% vs ulcers: 33%) had a recurrence after a mean follow-up of 16+/-13 months. The rate of surgical success was highest (81 vs 67 vs 25%) and the rate of recurrence was lowest (38 vs 90 vs 100%) with the sandwich technique in contrast to the graft or patch techniques used alone. CONCLUSIONS: AMT may be beneficial in the treatment of PEDs after PK, especially when applying the sandwich technique. Recurrences seem to be more frequent, if PK preceded AMT.
PURPOSE: To determine the primary success and recurrence rate of amniotic membrane transplantation (AMT) for the treatment of persistent corneal epithelial defects (PEDs) in eyes after penetrating keratoplasty (PK). DESIGN: Retrospective, non-randomized, observational case series. METHOD: AMT was performed in 24 eyes of 24 patients with erosions (n=6) or ulcers (n=18), which were resistant to medical therapy. All eyes had undergone one (42%) or more PKs before AMT. After the removal of epithelium and pannus (if present), one or more layers of AM ('graft' (n=3), 'patch' (n=5), 'sandwich'=combination of graft/patch (n=16)) were transplanted. Main outcome measures included 'surgical success' (epithelium closed within 4 weeks after AMT), and 'recurrence' (new epithelial defect developing during follow-up after surgical success). RESULTS: The rate of surgical success was 70% and was found to be inversely proportional to the number of previous PKs. Defects limited only to the centre of the graft had a higher success rate (central: 100%, non-central: 61%). A total of 44% successful eyes (erosions: 75% vs ulcers: 33%) had a recurrence after a mean follow-up of 16+/-13 months. The rate of surgical success was highest (81 vs 67 vs 25%) and the rate of recurrence was lowest (38 vs 90 vs 100%) with the sandwich technique in contrast to the graft or patch techniques used alone. CONCLUSIONS: AMT may be beneficial in the treatment of PEDs after PK, especially when applying the sandwich technique. Recurrences seem to be more frequent, if PK preceded AMT.
Authors: Miguel González-Andrades; Rosario Mata; María Del Carmen González-Gallardo; Santiago Medialdea; Salvador Arias-Santiago; Juliana Martínez-Atienza; Antonio Ruiz-García; Lorena Pérez-Fajardo; Antonio Lizana-Moreno; Ingrid Garzón; Antonio Campos; Miguel Alaminos; Gloria Carmona; Natividad Cuende Journal: BMJ Open Date: 2017-09-24 Impact factor: 2.692
Authors: Tobias Röck; Karl Ulrich Bartz-Schmidt; Johanna Landenberger; Matthias Bramkamp; Daniel Röck Journal: Ann Transplant Date: 2018-03-06 Impact factor: 1.530