AlShammari Ali Zain Abden M, Khouqeer Zohair, Medani Safaa, Elbashir Abdelgadir Zeinab, Alnefaie Zayed
College of Medicine, Al-Rayan Colleges, Medinah, SAU.
Department of Ophthalmology, King Faisal Specialist Hospital and Research Centre, Medinah, SAU.
Cureus. 2025 Jul 4;17(7):e87260. doi: 10.7759/cureus.87260. eCollection 2025 Jul.
Corneal wound healing plays a vital role in restoring ocular surface integrity following injury or disease. Both bandage contact lenses (BCLs) and amniotic membranes (AM) are non-pharmacologic interventions widely used in ocular surface disease management. This systematic review focuses on presenting high-level clinical evidence supporting the effectiveness of bandage contact lenses versus amniotic membrane in corneal wound healing. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching five medical databases for relevant scholarly papers. The search was limited to studies published from January 2010 to March 2024. These databases included PUBMED, Medline, Web of Science, Google Scholar, and ScienceDirect. The study assessed clinical trials, randomized controlled trials, and prospective studies involving patients with corneal ulcers. It included studies that reported outcomes such as corneal opacity density, neovascularization, and the healing period of epithelial defects. Two independent, experienced researchers screened the extracted papers for potential inclusion, and in cases of disagreement, they engaged in discussions to resolve the issue. Relevant data were extracted from the selected studies using a structured data collection form. The Cochrane risk of bias assessment scale was used to evaluate the risk of bias in clinical trials and randomized controlled trials, while the Newcastle-Ottawa Quality Assessment Scale (NOS) was applied to assess prospective/retrospective, cross-sectional, and cohort studies. The results of the study indicate that BCLs and amniotic membrane transplantation (AMT) are safe and effective treatments for dry eye disease and corneal lesions. In cases of severe ulcerative keratitis and neurotrophic keratitis, AMT was shown to improve healing outcomes. AMT was also found to be more effective in treating deep stromal ulcers. Additionally, it enhances ocular integrity and promotes anatomical restoration following corneal perforation. Furthermore, AMT demonstrated significant efficacy in treating dry eye disease (DED). When combined with a bandage contact lens, dehydrated AMT was found to reduce symptoms of DED. However, its effectiveness remains limited in certain cases. The study also revealed that amniotic membrane suspension (AM suspension) serves as a non-invasive alternative to conventional AMT. In conclusion, AMT was more effective in managing deep stromal ulcers and neurotrophic keratitis, especially when retained for longer durations. Bandage contact lenses were useful in managing post-surgical epithelial defects and enhancing membrane retention. Future research should investigate long-term outcomes and combined therapy protocols.
角膜伤口愈合在损伤或疾病后恢复眼表完整性方面起着至关重要的作用。绷带式隐形眼镜（BCL）和羊膜（AM）都是广泛用于眼表疾病管理的非药物干预措施。本系统评价的重点是提供高级别临床证据，支持绷带式隐形眼镜与羊膜在角膜伤口愈合方面的有效性。该研究遵循系统评价和Meta分析的首选报告项目（PRISMA）指南，在五个医学数据库中搜索相关学术论文。搜索仅限于2010年1月至2024年3月发表的研究。这些数据库包括PUBMED、Medline、科学网、谷歌学术和ScienceDirect。该研究评估了涉及角膜溃疡患者的临床试验、随机对照试验和前瞻性研究。它包括报告角膜混浊密度、新生血管形成和上皮缺损愈合期等结果的研究。两名独立、经验丰富的研究人员筛选提取的论文以确定是否可能纳入，如有分歧，他们会进行讨论以解决问题。使用结构化数据收集表从选定的研究中提取相关数据。Cochrane偏倚风险评估量表用于评估临床试验和随机对照试验中的偏倚风险，而纽卡斯尔-渥太华质量评估量表（NOS）用于评估前瞻性/回顾性、横断面和队列研究。研究结果表明，BCL和羊膜移植（AMT）是治疗干眼症和角膜病变的安全有效方法。在严重溃疡性角膜炎和神经营养性角膜炎的病例中，AMT显示出能改善愈合结果。还发现AMT在治疗深层基质溃疡方面更有效。此外，它能增强眼的完整性并促进角膜穿孔后的解剖结构恢复。此外，AMT在治疗干眼症（DED）方面显示出显著疗效。当与绷带式隐形眼镜联合使用时，发现脱水的AMT可减轻DED的症状。然而，在某些情况下其有效性仍然有限。该研究还表明，羊膜悬液（AM悬液）是传统AMT的一种非侵入性替代方法。总之，AMT在管理深层基质溃疡和神经营养性角膜炎方面更有效，尤其是当保留较长时间时。绷带式隐形眼镜在管理手术后上皮缺损和增强膜的保留方面很有用。未来的研究应调查长期结果和联合治疗方案。
