Purchase this article with an account.
P.L. Dighiero, M. Mercié, J. Gicquel; Early Use of Amniotic Membrane Transplantation Combined With Topical Steroids in Severe Bacterial Keratitis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2767.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine whether amniotic membrane transplantation (AMT) can be used to promote severe bacterial keratitis healing and improve final BCVA. Methods: Prospective, comparative case series featuring patients with severe acute bacterial keratitis: 12 treated with topical antibiotherapy and delayed corticotherapy / 9 treated with AMT associated with immediate maximal topical antibiotic and corticosteroid treatment. Single or multilayer graft with epithelial side was performed. Main outcome measurements were pain relief, wound healing of the corneal ulcerations, decrease of stromal inflammation and BCVA. Results:The mean follow up was 9 months (6 to 17 months). AMT was performed once in 7 cases and twice in 2 cases. Improvement of pain was immediate after surgery in all cases with AMT, although most patients were still suffering after 5 days in the non grafted group. Stromal necrosis extension was more limited and improvement of stromal inflammation was noted more quickly in the AMT group (within 7 days (range 5–15 days) versus 16 days (range 11–21). To perform statistical analysis, decimal chart values were converted to the logMar scale [VA = –log10(Decimal VA)]. Mean final BCVA was 0,3 in the AMT group versus 0,5 in the non grafted group. Conclusions:In this first series of AMT used in association with steroids and antibiotic topical treatment, we found that our new protocol enabled faster epithelial healing, helped to stop stromal inflammation, and most of all achieved better final BCVA. This association will probably represent promising therapy for severe bacterial keratitis.
This PDF is available to Subscribers Only