Bulut Okyanus, Musayeva Gunel, Selver Ozlem Barut
Department of Ophthalmology, Ege University Medical Faculty Hospital, Bornova, 35100, Izmir, Turkey.
Int Ophthalmol. 2023 Mar;43(3):915-923. doi: 10.1007/s10792-022-02493-1. Epub 2022 Sep 7.
To evaluate the effectiveness of cryopreserved human amniotic membrane transplantation (hAMT) in patients with infectious ulcerative keratitis.
A retrospective cohort study based on medical records of patients who underwent hAMT procedure over a 2-year period (2020-2021) was conducted at Ege University Hospital, Turkey. Cryopreserved hAM was used. Best corrected visual acuity (BCVA) was measured with the Snellen chart. Detailed ophthalmological examination was performed at all visits. Treatment success was defined as complete healing including disappearance of corneal infiltrates, epithelial defect closure, reduction in anterior segment reaction.
A total of 13 eyes of 12 patients were diagnosed with ulcerative keratitis between 2020 and 2021. hAMT was performed in severe keratitis patients in which corneal infiltrates extending to middle to deep stromal and patients with neurotrophic component, in other words, having trouble for wound healing. The mean age was 60.9 ± 18.7 years, and 66.6% of the patients were male. Average ulcer horizontal diameter was 9.7 ± 2.8 mm. A single-layer human amniotic membrane (hAM) was transplanted 92.3% of eyes. Overlay technique was used in all patients for hAMT. The mean residence time of the amniotic membrane on the ocular surface was 14.1 ± 10.2 days. The mean time from the first presentation to the hAM transplantation was 9.7 ± 6.8 days. The average hospitalization time of all patients was 15 ± 12.1 days, pre-hAMT was 10.2 ± 7.3 days and post-hAMT was 4.8 ± 9.1 days. The mean follow-up time was 3 months. Recovery response was positive in 76.9%. Average healing time was 32.1 ± 14.04 days.
hAMT was effective in the treatment of infectious ulcerative keratitis by accelerating and supporting wound healing. Performing hAM transplantation at the early stages of the disease and prolonged residence of membrane on the ocular surface increase the success of the treatment and moreover shortens hospitalization time.
评估冷冻保存的人羊膜移植（hAMT）治疗感染性溃疡性角膜炎患者的有效性。
在土耳其伊兹密尔埃杰大学医院，基于2020年至2021年期间接受hAMT手术患者的病历进行了一项回顾性队列研究。使用冷冻保存的人羊膜。用斯内伦视力表测量最佳矫正视力（BCVA）。每次就诊时均进行详细的眼科检查。治疗成功定义为完全愈合，包括角膜浸润消失、上皮缺损闭合、眼前段反应减轻。
2020年至2021年期间，共有12例患者的13只眼被诊断为溃疡性角膜炎。hAMT用于治疗角膜浸润延伸至基质中深层的重度角膜炎患者以及伴有神经营养成分（即伤口愈合困难）的患者。平均年龄为60.9±18.7岁，66.6%的患者为男性。溃疡平均水平直径为9.7±2.8毫米。92.3%的眼移植了单层人羊膜（hAM）。所有患者的hAMT均采用覆盖技术。羊膜在眼表的平均停留时间为14.1±10.2天。从首次就诊到hAM移植的平均时间为9.7±6.8天。所有患者的平均住院时间为15±12.1天，hAMT前为10.2±7.3天，hAMT后为4.8±9.1天。平均随访时间为3个月。76.9%的患者恢复反应为阳性。平均愈合时间为32.1±14.04天。
hAMT通过加速和支持伤口愈合，在治疗感染性溃疡性角膜炎方面有效。在疾病早期进行hAM移植以及延长羊膜在眼表的停留时间可提高治疗成功率，且缩短住院时间。
