Posters

Clinical outcome of fresh amniotic membrane transplantation using suturing technique in patients with corneal ulcers

Poster Details

First Author: R. Setyowati INDONESIA

Co Author(s):    K. Goenawan   S. Prawiroranu                 

Abstract Details

Purpose:

Severe corneal ulcer requires immediate treatment with intensive topical broad-spectrum antibiotics, which are potentially toxic to the corneal epithelium and contribute to a prolonged corneal epithelial defect. Fresh Amniotic membrane transplantation (AMT) as an adjuvant treatment counterbalances the epithelial toxicity of fortified antibiotic eye drops while exerting as antimicrobial actions and acting as a long-term drug delivery system. From previous study suggest Fresh AMT can be resorbed more quickly than that dried amnion. This study evaluate the efficacy and and factors associated with success rate of fresh AMT using suturing technique

Setting:

Dr Sardjito General Hospital in Yogyakarta, Indonesia

Methods:

Retrospective cohort study of 28 patients (28 eyes) with severe corneal ulcer unresponsive to medical treatment. All patients underwent multilayer fresh AMT using suturing technique from January to December 2015. This study analysed the efficacy of fresh AMT in relieving pain, inflammation, corneal epithelial healing and improvement of visual acuity. Other associated factors such as hypopyon, size of corneal defect, antibiotic and autologous serum eye drops were evaluated. Surgical success was defined as complete epithelialisation of the ocular surface as demonstrated by negative fluorescein staining without recurrence within 1 month.

Results:

Corneal epithelial healing was effectively restored at 25 days post fresh AMT. There were statistically significant difference in patients’ inflammation (p= 0,000) and pain scale post operative (p=0,000). There were no significant difference in patients visual acuity post operative. Autologous serum eye drops significantly correlated with the improvement of corneal ulcer patients (p = 0,023). Other factors are not correlated such as size of corneal defect, hypopyon, leucocyte count and neutrofil count. Failure was noted in 7 patients (25%) because of persistent corneal defect. No patient developed major immediate postoperative complications

Conclusions:

Fresh AMT using suturing technique can successfully treat severe corneal ulcer unresponsive to medical treatment by promoting epithelial healing, relieve the pain and inflammation. Medical treatment including topical antibiotic still needed. Autologous serum eyedrops also improving corneal ulcer patients. It can be used as adjunctive treatment for severe corneal ulcer by restoring corneal stromal thickness

Financial Disclosure:

NONE