A STUDY TO EVALUATE THE HEALING (RE-EPITHELIALISATION) TIME AND OUTCOMES OF CORNEAL PERFORATION AND DESCEMETOCELE AFTER AMNIOTIC MEMBRANE GRAFTING

Abstract

Background: Corneal perforation and Descemetocele is a potential disabling complication, caused by diseases like infections, autoimmune diseases, trauma etc. Surgical approaches, such as tissue adhesive, bandage contact lens, AMT (Amniotic Membrane Transplantation), transpositional conjunctival ap, and therapeutic Penetrating Keratoplasty (PK), are available. AMG is one of good alternative for the management of small or impending corneal perforation to reconstruct the surface. AMT can prevent urgent need of penetrating keratoplasty. The aim of present study is to assess the efcacy of AMG in treating corneal perforation ≤ 2mm and descemetocele of any size and to evaluate the time of healing and stability of corneal surface. This is a prospective interventional analytical study Method: conducted on all men and women with a diagnosis of corneal perforation ≤2mm or descemetocele of any size attending our institute for period of 8 months. All patients were treated with multi-layered amniotic membrane grafting and were followed for 10 months postoperatively. Results: We included a total of 59 cases. There were 31 female and 28 male patients. The mean age (±SD) was 50.93±17.57 years. There were 30 cases of corneal perforation and 29 cases of descemetocele. On nal follow up, 67.79% patients successfully achieved reepithelization. Epithelial closure was observed within rst 4 weeks of grafting in 24 (40.68%) patients, between 5 to 8 weeks in 9 (20.93%) patients and in 7 (16.27%) patients the healing occurred after 8 weeks till 10 months after AMT. No epithelial closure was achieved in the remaining 19 (32.20%) patients. There was no statistically signicant difference in relation to age groups and gender when compared to outcome (Success and Failed graft) (p=0.869 and 0.452 respectively). Baseline BCVA (Best Corrected Visual Acuity) did not show statistically signicant difference between the different subgroups (p-value=0.668) and the difference was statistically highly signicant postoperatively (p<0.0001). BCVA post operatively, on nal assessment, was observed statistically signicant in the success group (p<0.001) with LogMar values of 1.84±0.58 preoperatively to 0.94±0.59 on nal follow up. In this study, we observed that AMT has good success rate and is a Conclusion: cost effective and non-invasive method in the treatment most cases of various etiologies of small corneal perforations and descemetocele.