Abstract
Purpose :
Amniotic Membrane Transplantation (AMT) has been used for ocular surface disease (OSD) management due to its many biological functions. The aim of this study is to determine surgical indications for patients who underwent AMT due to OSD and its success in achieving desired postoperative outcomes.
Methods :
Retrospective chart review. Patients included were those who underwent AMT due to OSD from January 2017 to October 2022. Data collected: preoperative diagnosis, surgical indication and technique, pre and post-operative uncorrected (UCVA) and best-corrected visual acuity (BCVA) (logMAR), intraocular pressure (IOP) (mmHg), trans and post-operative complications, resolutions, and achievement or lack of desired outcome.
Results :
246 eyes of 215 patients were included. Predominance of right eye (n, %) (134, 54.47%), and male gender (126, 51.21%). Mean age was 48 ±19 years and mean follow-up period of 10.8 ±12.6 months. Main surgical indications were: pterygium (93, 37.8%), perforation (37, 15.04%), burns (30, 12.19%), neoplasms (28, 11.38 %), ocular surface reconstruction (25, 10.16%), epithelial defect/ulcer (20, 8.13%), and limbal stem cell deficiency (LSCD) (13, 5.28 %). Pre-op UCVA and BCVA were 1.33 and 1.16 logMAR, with significant post-op improvement to 1.14 and 0.94 logMAR, respectively (p<0.001). Pre- and post-op IOP levels were of 13.84 and 13.69 mmHg, respectively (p=0.83). Intraoperative and postoperative complications occurred in 2 (0.81%) and 110 (44.71%) eyes, respectively, most common being pterygium recurrence (22, 20%), symblepharon (20, 18.18%), and epithelial defect (13, 11.81%); and 48 (19.51%) eyes required reintervention. In 178 (72.35%) eyes, the desired postoperative results were achieved for the following conditions: neoplasms (28, 100%); epithelial defect/ulcer (16, 80%); pterygium (71, 76.34%); perforation (27, 72.97%); burns (18, 60%); ocular surface reconstruction (13, 52%); and LSCD (5, 38.46%).
Conclusions :
AMT is a safe procedure that can be performed for the management of neoplasm and pterygium resection, epithelial defect, ulcer, and ocular perforation patching, with successful surgical and visual outcomes, as well as stability in IOP levels. On the other hand, its use in ocular burns, ocular surface reconstruction, and LSCD displayed a higher rate of negative outcomes. Further research is needed to help predict surgical failure and prevent unfavorable results.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.