Amniotic membrane transplantation in the management of severe ocular surface disease: indications and outcomes.

Since 1995, with the availability of cryopreserved amniotic membrane (AM), the use of AM as a patch or graft for ocular surface reconstruction has become recognized as an important alternative for treatment of persistent epithelial defects and sterile ulceration that are refractory to conventional therapy. A major problem with evaluating the efficacy of AM transplantation is the lack of controlled clinical studies. Moreover, for some diseases there is no accepted "standard" therapy, and the incidence of the disease is too low to allow proper randomization. In this review, we have attempted to assess the indications and outcomes of AM transplantation based on 661 cases reported in the peer-reviewed literature. Successful outcome was defined as the healing of an epithelial defect (corneal or conjunctival) over a specified time period and the lack of induced motility disturbance.