Sutureless dehydrated amniotic membrane for persistent epithelial defects

Abstract

Purpose: To report outcomes of a sutureless dehydrated amniotic membrane for persistent epithelial defects (PED). Methods: This retrospective study included consecutive patients with a PED (⩾14 days) treated with a sutureless dehydrated amniotic membrane and bandage contact lens (BCL). Included were patients with an epithelial defect that did not respond to treatment with a BCL. Excluded were patients with a follow-up time of less than 3 months. Results: Nine eyes of eight patients with a mean age of 54.6 ± 10.9 years (range 38–73 years) were included in this study. The main etiology of the PED was limbal stem cell deficiency ( n = 5/9) due to Stevens-Johnson Syndrome ( n = 2/5), glaucoma procedures ( n = 1/5), graft-versus-host disease ( n = 1/5) and severe allergic reaction ( n = 1/5). Additional etiologies included neurotrophic cornea ( n = 2/9), post keratoplasty and severe dry eye disease ( n = 2/9). Time from PED presentation to amnion treatment was 65.9 ± 60.6 days (range 15–189 days) with the area of the PED being 11.0 ± 12.2 mm2 (range 1.0–36.0 mm2). The amnion was absorbed within 2 weeks in 100% of the cases. Following insertion of the amnion, resolution of the PED was achieved in 8/9 eyes (89%) without the need for additional interventions within 17.8 ± 9.6 days (range 7–35 days). LogMAR BCVA improved from 0.94 ± 0.88 to 0.37 ± 0.25 ( p = 0.036) with no complications or recurrences recorded. Conclusions: Sutureless dehydrated amniotic membrane achieved resolution of PEDs secondary to various etiologies in 89% of eyes with a significant improvement in vision demonstrated. Further studies are needed to assess long term safety and effectiveness.