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Br J Ophthalmol 84:826-833 doi:10.1136/bjo.84.8.826
  • Original Article
    • Clinical science

Amniotic membrane transplantation for severe neurotrophic corneal ulcers

Table 1

Demographic and clinical data

Case Age Sex Causes of ulcer Eye Associated surface problems/duration of ulcers (months) Previous surgery Previous management for surface problems AMT Subsequent surgery VA-pre VA-post Other ocular problems Epithelial healing (days) Follow up (months) Complication
1 69 M (1) HSV
(2) HSV, PKP
LE KCS, keratouveitis, bacterial superinfection/2.8 (2) perforation/1.2 (1) Glaucoma surgery with Baeveldt
(2) PKP
Punctal occlusion AMT+bandage CL (2) AMT (3 layers) (1) PKP
(2) Partial tarsorrhaphy (34 days later) PKP+partial tarsorrhaphy (59 days later)
(1)LP
(2) HM
(1) HM
(2) LP
Parkinson's disease, glaucoma, optic nerve atrophy (1) 14
(2) 50*
(1) 19
(2) 24
(2) Non-healing and perforation until repeat PKP+tarsorrhaphy
2 81 M HZO, PKP LE 50% thinning/2.3 PKP (2x), ECCE Conjunctival flap, patching AMT (3 layers) + bandage CL 4/200 20/200 Choroidal detachment, hypotony 20 38
3 78 M HZO, PKP LE Trichiasis, 75% thinning/3.1 PKP (2x), ECCE Partial tarsorrhaphy AMT (3 layers) PKP+AMT as patch HM 20/50 13 26
4 47 F HZO LE KCS, 20% thinning/2.5 AMT as patch CF 20/80 AIDS 18 8
5 78 M HZO, DM, PKP LE Trichiasis, KCS, 30% thinning/1.8 PKP Punctal occlusion, Botox ptosis, lid margin eversion AMT Partial tarsorrhaphy (27 days later) HM 20/200 74* 26.5 Non-healing until 47 days after tarsorrhaphy
6 86 F DM RE 25% thinning/2.0 ECCE, cryotherapy AMT+ bandage CL NLP NLP NVG, optic nerve atrophy 20 3.7
7 51 M DM RE LE KCS, lagophthalmos, 50% thinning, both eyes/3.5 Patching, punctal occlusion, Botox ptosis AMT (2 layers) Partial tarsorrhaphy (14 days later) (1) 4/200 (2) 2/200 (1) 20/200 (2) 20/300 PDR (1) 34*
(2) 34*
(1) 23.3
(2) 23.3
Non-healing until 20 days after tarsorrhaphy
8 65 M DM LE 40% thinning/3.6 Glaucoma surgery with Seton AMT + AMT as patch HM LP NVG 34 8
9 30 M DM, PKP RE KCS/3.2 ECCE, PKP Punctal occlusion AMT+ bandage CL 2/200 2/200 34 52
10 4 M Radiation LE KCS, limbal deficiency/4.2 Punctal occlusion AMT+ Lateral tarsorrhaphy HM 1/200 Retinoblastoma 11 22
11 71 M Radiation, PKP RE KCS, trichiasis, limbal deficiency, 75% thinning/3.6 PKP (3x) Punctal occlusion, Partial tarsorrhaphy AMT (3 layers)+ AMT as patch 20/200 HM Malignant lymphoma of orbit 6 19
12 62 M Removal of Acoustic Neuroma RE Facial palsy, KCS 75% thinning/4.5 Punctal occlusion, Botox ptosis, gold weight, bandage CL AMT (3 layers)+AMT as patch Partial tarsorrhaphy and removal of gold weight (7 days later) 20/200 20/200 Acoustic neuroma 6 8.5
13 70 M PKP, DM RE Failed graft, limbal deficiency, sterile ulcer with infiltration/2.4 PKP (3X) AMT + Sectorial KLAL HM HM 16 6
14 61 F PKP LE Band keratopathy, failed graft, cicatricial entropion, trichiasis, KCS/4.5 PKP, ECCE Punctal occlusion lid margin eversion AMT+AMT as patch Punctal occlusion HM 20/400 Glaucoma 16 6
15 86 F PKP LE Band keratopathy, failed graft/3.6 PKP, vitrectomy scleral bucking AMT + AMT as patch NLP NLP RD, glaucoma, rheumatoid arthritis 8 6
  • AIDS = acquired immune deficiency syndrome; AMT = amniotic membrane transplantation; CF = counting fingers; CL = contact lens; DM = diabetes mellitus; ECCE = extracapsular cataract extraction; HM = hand movement; HSV = herpes simplex virus; HZO = herpes zoster ophthalmicus; KCS = keratoconjunctivitis sicca; KLAL = keratolimbal allograft; LP = light perception; NLP = no light perception; NVG = neovascular glaucoma; PDR = proliferative diabetic retinopathy; PKP = penetrating keratoplasty; RD = retinal detachment; VA = visual acuity.

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