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Petja I. Vassileva, Yordanka Kirilova, Tatyana Hergeldzhieva-Fileva; Amniotic Membrane Transplantation For Persistent Corneal Epithelial Defects And/or Graft Rejection After Penetrating Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5162.
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To evaluate the effect of amniotic membrane transplantation (AMT) on persistent epithelial defects and/or graft rejection in patients after penetrating keratoplasty (PKP).
Subjects were all patients with corneal transplantation performed at the University Eye Hospital "Prof. Pashev" Sofia between August 2008 and August 2010 who developed persistent epithelial defects and/or graft rejection episodes during follow-up. Medical records and treatment procedures were reviewed retrospectively. Two treatment options were applied: 1) lubricants and bandage contact lens; and 2) AMT: both of them combined with standard treatment after PKP and graft rejection episodes. Indications for PKP did not differ in both groups. Efficacy of the applied therapy on graft survival was evaluated.
PKP was performed on 112 eyes (110 patients). Persistent epithelial defects and/or graft rejection episodes developed in 38 eyes (34%). Group 1 - 13 patients, were treated with lubricants and bandage contact lens until April 2009. Then amniotic membrane became available, and Group 2 - 25 patients, were treated with AMT. The treatment led to full recovery in 5 patients (38.5%) in the first group and 19 patients (76%) in the second group. AMT was well tolerated by the patients in relieving the pain, irritation and photophobia. In the first group delayed epithalization of the cornea was observed as compared to the second group. Graft failure was diagnosed in 8 patients (61.5%) in the first group and only in 6 patients (24%) in the second group.
AMT is beneficial for treatment of persistent epithelial defects and/or graft rejection episodes and significantly improves graft survival after PKP.
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