engleski

Multilayer versus monolayer amniotic membrane transplantation for deep corneal ulcer treatment

Purpose:To evaluate the efficacy of multilayer amniotic transplantation (AMT) for reconstruction of corneal stroma and epithelium and to compare this method with previously used monolayer technique. Patients and methods: This clinical study included 80 patients suffering from various corneal diseases unresponsive to conventional treatement. 35 patients were treated by monolayer AMT and 45 by multilayer AMT ( more than one layer placed over cornea). Indications for monolayer AMT included postkeratitic ulcer (n=15), neurotrophic ulcer (n=10), epithelial defecets ( n=10), while indications for multylayer AMT included postkeratitic ulcer (n=25), neurotrophic ulcer (n=6), epithelial defects ( n=10), perforation (n=3) and Mooren&#8217 ; s ulcer ( n=1). Results: Following transplantation AM gradually dissolved (2-5 weeks). The study showed that multilayer AMT was more succesfull than monolayer AMT in treatement of poskeratitic ulcers ( 72% healed compared to 54 %) , neurotrophic ulcers ( 66 % compared to 60 %) and epithelium defects ( 90 % compared to 70 %). Corneal perforation and Mooren&#8217 ; s ulcer were treated only by multilayer AMT. Conclusion: Use of multilayer AMT potentiates healing effects of AM by amplifying concentrations of useful factors secreted from stroma. Muliylayer AMT showed better results in treatment of corneal ulcers and epithelial defects. It also postponed a need for corneal transplantation.

multilayer; monolayer; amniotic membrane; transplantation

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