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H. A. Hashem, L. Liang, H. Sheha; Evaluation of Amniotic Membrane Treatments in Reducing Haze After Photorefractive Keratectomy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2858. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of amniotic membrane patch graft (AMG) versus amniotic membrane extract (AME) on re-epithelialization time, postoperative pain, haze and refractive outcome after photorefractive keratectomy (PRK) for myopia.
20 patients undergoing bilateral PRK for correction of myopia were randomized to receive AM treatment in one eye: AMG (8.0 mm disc) attached to a bandage contact lens (BCL) or AME (100 µg/ml eye drops) with BCL. The fellow eye of each patient was treated with BCL and placebo. In addition, all patients received routine antibiotic steroid eye drops. Visual Analogue Pain Charts were used to record pain levels for 4 days after surgery. Serial digitized retro-illumination photography was used to assess rates of epithelial healing. The BCLs were removed after one week, and the relative haze scale was quantified, and surface epithelial quality was monitored using topography. At 6-month period, visual performance was assessed by measuring refractive outcome, best-corrected visual acuity, objective haze, halo, and glare.
The preoperative findings were overall statistically similar between groups; the mean spherical equivalent refraction was -5.5 ± 1.5 D. Overall pain scores were higher with BCL alone at 1 day (P =.001) and 4 days (P =.025). There was no statistically significant difference in pain scores between AMG and AME groups (P=.62). Re-epithelialization was completed after three days, without any significant difference between groups. At 1 week, all patients showed topographic irregularity that completely resolved by 1 month. Haze was significantly reduced in AMG and AME groups. No statistically significant difference was seen between treatment groups in any of the parameters monitoring visual performance.
Amniotic membrane as a tissue or extract did not affect re-epithelialization time, but appears to potentially reduce postoperative pain and haze that can impact visual performance following PRK.
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