Sutureless dehydrated amniotic membrane for persistent epithelial defects.

Abstract

PURPOSE\nTo report outcomes of a sutureless dehydrated amniotic membrane for persistent epithelial defects (PED).\n\n\nMETHODS\nThis retrospective study included consecutive patients with a PED (⩾14\u2009days) treated with a sutureless dehydrated amniotic membrane and bandage contact lens (BCL). Included were patients with an epithelial defect that did not respond to treatment with a BCL. Excluded were patients with a follow-up time of less than 3\u2009months.\n\n\nRESULTS\nNine eyes of eight patients with a mean age of 54.6\u2009±\u200910.9\u2009years (range 38-73\u2009years) were included in this study. The main etiology of the PED was limbal stem cell deficiency (n\u2009=\u20095/9) due to Stevens-Johnson Syndrome (n\u2009=\u20092/5), glaucoma procedures (n\u2009=\u20091/5), graft-versus-host disease (n\u2009=\u20091/5) and severe allergic reaction (n\u2009=\u20091/5). Additional etiologies included neurotrophic cornea (n\u2009=\u20092/9), post keratoplasty and severe dry eye disease (n\u2009=\u20092/9). Time from PED presentation to amnion treatment was 65.9\u2009±\u200960.6\u2009days (range 15-189\u2009days) with the area of the PED being 11.0\u2009±\u200912.2\u2009mm2 (range 1.0-36.0\u2009mm2). The amnion was absorbed within 2\u2009weeks in 100% of the cases. Following insertion of the amnion, resolution of the PED was achieved in 8/9 eyes (89%) without the need for additional interventions within 17.8\u2009±\u20099.6\u2009days (range 7-35\u2009days). LogMAR BCVA improved from 0.94\u2009±\u20090.88 to 0.37\u2009±\u20090.25 (p\u2009=\u20090.036) with no complications or recurrences recorded.\n\n\nCONCLUSIONS\nSutureless dehydrated amniotic membrane achieved resolution of PEDs secondary to various etiologies in 89% of eyes with a significant improvement in vision demonstrated. Further studies are needed to assess long term safety and effectiveness.