Surgical outcomes of Amniotic Membrane Transplantation in impending or full-thickness corneal perforation.

Abstract

Purpose : We aimed to determine the efficacy and surgical outcomes of crio-preserved Amniotic Membrane Transplantation in impending (i.e. descemetocele) or full-thickness corneal perforation.

Methods : A retrospective chart review that included patients who underwent AMT due to impending or full-thickness corneal perforation. Data collected was preoperative diagnosis, surgical indication, pre- and post-operative uncorrected (UCVA) and best-corrected visual acuity (BCVA) (LogMAR), intraocular pressure (IOP) (mmHg), trans and postoperative complications and their resolutions. The primary outcome was defined as a complete closure of the corneal wound.

Results : A total of 33 eyes from 31 patients were included, of which 29 were in the full-thickness perforation group, and 4 in the descemetocele group. Mean follow-up period was 15.84 ± 13.43 months. Pre-op UCVA and BCVA improved slightly post-op, and IOP levels were maintained. There were no intraoperative complications. Postoperative complications were found in 11 eyes, with recurrent perforation the most common, predominantly in patients with autoimmune disease diagnosis vs non-autoimmune etiologies (p<0.002). 11 patients from the full-thickness corneal perforation group required surgical re-intervention. Complete closure of the corneal wound was achieved in 25 eyes overall.

Conclusions : AMT is a safe procedure that can be performed for the management of corneal imminent or full-thickness perforation, with successful surgical outcomes, as well as stability in visual acuity and IOP levels. Patients with autoimmune diagnosis have a worse prognosis compared to those with non-autoimmune etiologies. Further research is needed to help predict surgical failure and prevent unfavorable results.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.