Outcome of amniotic membrane transplantation for corneal diseases in a tertiary referral center

To investigate the outcome of amniotic membrane transplantation (AMT) performed in a tertiary referral cornea clinic and to define factors associated with reconstructive success. This retrospective analysis included 157 AMTs performed in 101 eyes of 96 adults. Only the first surgery of each eye (95 eyes of 90 patients) was included for statistical purposes. The primary outcome was post-operative epithelial closure within 8 weeks, and secondary outcomes were disease regression (8 weeks after epithelial closure) and re-AMT. Logistic regression models were used to assess (pre-)surgical variables for primary outcome. Eyes with limbal stem cell deficiency, pterygium or ocular surface neoplasia showed higher odds of epithelial closure within 8 weeks compared to eyes with ulcus (OR = 24.75, 95% CI 2.95–207.35, <i>p</i> = 0.0031). If corneal perforation was the indication for AMT surgery, this was associated with a decreased odds of primary healing compared to wound healing disorder (OR = 0.20, 95% CI 0.069–0.60, <i>p</i> = 0.004). Corneal disease recurrence was rare (two cases of corneal ulceration). AMT success is dependent on the severity of structural damage and related inflammation of the recipient cornea.

旨在探究三级转诊角膜诊所实施羊膜移植（AMT）的疗效，并明确与重建成功相关的影响因素。本回顾性分析纳入96名成人101只眼所接受的157次AMT手术；为统计目的，仅保留每只眼的首次手术数据（90例患者的95只眼）。主要观察指标为术后8周内上皮闭合情况，次要指标包括疾病消退（上皮闭合后8周）及再次AMT手术需求。采用逻辑回归模型评估（术前）手术变量对主要指标的影响。结果显示：与角膜溃疡患者相比，存在角膜缘干细胞缺乏、翼状胬肉或眼表肿瘤的患眼在8周内上皮闭合的几率显著更高（OR=24.75，95%CI 2.95–207.35，p=0.0031）；若手术指征为角膜穿孔，则其初次愈合几率较伤口愈合障碍患者降低（OR=0.20，95%CI 0.069–0.60，p=0.004）。角膜疾病复发率较低（仅2例角膜溃疡复发）。结论表明，AMT的成功与否取决于受体角膜结构损伤的严重程度及相关炎症反应。