Amniotic membrane transplantation for severe neurotrophic corneal ulcers

Aims-To evaluate whether amniotic membrane transplantation can be an effect ive alternative treatment for neurotrophic corneal ulcers. Methods-Amniotic membrane transplantation was performed in 16 eyes of 15 pa tients with neurotrophic corneal ulcers and vision equal to or worse than 2 0/200. The neurotrophic state was developed following keratoplasty (four ey es), herpes tester ophthahmicus (four eyes), diabetes mellitus (four eyes), radiation (two eyes), removal of acoustic neuroma with neuroparalysis tone eye), and herpes simplex keratitis tone eye). Results-During a mean follow up period of 18.8 (SD 13.0) months, one to thr ee layers of amniotic membrane with or without additional membrane as a pat ch were used for 17 procedures in 16 eyes for persistent neurotrophic corne al ulcers. All but four (76.4%) instances of amniotic membrane transplantat ion achieved rapid epithelialisation in 16.6 (9.0) days. Of the four eyes s howing delayed healing, three eyes healed by tarsorrhaphy, and the remainin g one eye with corneal perforation required penetrating keratoplasty and ta rsorrhaphy. Two eyes gained vision better than 20/200. The healed corneal s urface was accompanied by reduced inflammation. Conclusion-Amniotic membrane transplantation can be considered an effective alternative for treating severe neurotrophic corneal ulcers.