Role of multilayered amniotic membrane transplantation for the treatment of resistant corneal ulcers in North India.

To study the role of multilayer amniotic membrane transplantation (AMT) in the treatment of non-healing corneal ulcers. This study included 28 patients with non-healing bacterial corneal ulcers. AMT was performed using the 'overlay on-inlay' technique'. The outcome was assessed in terms of best corrected visual acuity (BCVA), corneal re-epithelization, graft/tissue edema and vascularity, graft melting, graft retraction, infection of graft and surface necrosis. The success rate of ulcer healing was 82.1 % (23 patients) 1 month after surgery, 78.5 % (22 patients) after 3 months and 75 % (21 patients) after 6 months. In the early post-operative period, BCVA deteriorated in all patients (perception of light to hand movement) but improved later. In 26 of the 28 patients (92.8 %) graft retraction occurred after 1 month and neovascularization was seen in 17 of the 28 patients (60.7 %). Multilayer AMT using an overlay on-inlay graft in non-healing bacterial corneal ulcers is a good option in terms of ulcer healing and symptomatic improvement.