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 (2 cases of corneal ulceration). AMT success is dependent on the severity of structural damage and related inflammation of the recipient cornea.

本研究旨在探究三级转诊角膜诊所开展的羊膜移植术（amniotic membrane transplantation, AMT）的临床效果，并明确与重建成功相关的影响因素。本次回顾性分析纳入了96名成人的101只眼共计157例羊膜移植术。为满足统计学分析需求，仅纳入每只眼的首次手术数据（90例患者的95只眼）。本研究的主要结局指标为术后8周内的角膜上皮愈合情况，次要结局指标为疾病消退（上皮愈合后8周评估）以及再次行羊膜移植术。采用逻辑回归模型分析主要结局指标相关的术前变量。与角膜溃疡患者相比，合并角膜缘干细胞缺乏症、翼状胬肉或眼表肿瘤的患眼在8周内实现上皮愈合的概率更高（比值比OR=24.75，95%置信区间CI=2.95~207.35，P=0.0031）。与伤口愈合障碍患者相比，以角膜穿孔为羊膜移植术指征的患眼初次愈合的概率更低（OR=0.20，95%CI=0.069~0.60，P=0.004）。角膜疾病复发率极低，仅出现2例角膜溃疡复发案例。羊膜移植术的成功与否取决于受体角膜的结构损伤程度及相关炎症水平。