Table 4

Published studies of AM transplantation for microbial keratitis

Author, yearNoStudy designControlsOrganismsAim of treatmentResults and comments
Kim,74 200121Prospective interventional case seriesNoneMixed organismsPromotion of corneal healingSutured AM used without concurrent topical antimicrobial. 82% achieved epithelial healing at 1 month.
Chen,71 20026Retrospective case seriesNonePseudomonas aeruginosaPromotion of corneal healingSutured AM used with concurrent topical antibiotic. Rapid re-epithelialisation achieved in five. One case required evisceration.
Chen,72 200623Retrospective case seriesNoneFungiPromotion of corneal healingSutured AM used with concurrent topical antibiotic and antifungal. Two cases needed therapeutic keratoplasty for perforation. Nine additional patients had delayed keratoplasty for visual rehabilitation.
Gicquel,73 200712Prospective interventional case seriesNoneBacteriaReduction of inflammation and promotion of healingSutured AM used with concurrent topical antibiotic. Complete epithelial healing achieved in all cases. Ten required repeat AM transplants.
Sheha,70 20093Retrospective case seriesNoneBacteriaReduction of inflammation and promotion of healingAM clipped onto polycarbonate ring without sutures. Concurrent topical antibiotics not used. Corneal healing achieved in all cases, two required repeat AM transplants.
Kheirkhah,69 201225Prospective interventional case series with retrospective controlsYesP aeruginosaPromotion of corneal healingSutured AM used without concurrent topical antibiotics. Cases (n=14) had antibiotic therapy and AM. Controls (n=11) had antibiotic therapy alone. At final follow-up cases had less corneal scarring and better UCVA compared with controls.
Mohan,68 201428Prospective interventional cases seriesNoneBacteriaPromotion of corneal healingSutured AM used without concurrent topical antibiotics. Corneal epithelialisation achieved within 1 month in 82%. Seven patients required penetrating keratoplasty.
Abdulhalim,75 201540Randomised clinical trialYesMixed organismsPromotion of corneal healingCases (n=20) underwent sutured AM transplantation. Controls (n=20) received a conjunctival flap, both with concurrent topical antimicrobials. There was no significant difference in epithelialisation time or visual acuity improvement.
  • AM, amniotic membrane; UCVA, uncorrected visual acuity.