Use Of Amniotic Membrane Applied With A Specialised Bandage Contact Lens On Intransient Dry Eye

To assess changes in ocular surface signs and symptomatology following sutureless application of dehydrated amniotic membrane (AM) under a specialised bandage contact lens (BCL) in patients with moderate-to-severe dry eye disease (DED).

Aston university dry eye clinic, Birmingham, UK.

This prospective interventional trial enrolled 35 patients diagnosed with intransient moderate-to-severe DED (OSDI >30 on current treatment). Assessments followed a 30-day period on current treatment, followed by 30-days following two successive bilateral 3–4-day applications of AM (17mm with a 6mm central aperture; Omnigen®) under a 18mm BCL (OmniLenz). Symptomatology: Ocular Surface Disease Index (OSDI), Dry Eye Questionnaire 5 (DEQ-5) and Symptom Assessment Questionnaire iN Dry Eye (SANDE). Signs: tear meniscus height (TMH), non-invasive breakup time (NIBUT), ocular hyperaemia, lipid layer thickness (LLT), corneal and conjunctival staining (CornS/ConjS), and lid wiper epitheliopathy length and width (LWE) with (OCULUS Keratograph 5M)

While symptomology remained stable during the 30-day pre-AM treatment period, there was a significant decrease in OSDI scores from 55.81 to 32.28 (p<0.001), DEQ-5 from 17.08 to 11.29 (p=0.045), SANDE frequency from 64.50 to 41.69 (p=0.001), SANDE severity from 58.23 to 39.31 (p=0.001) 30 days post-AM treatment. In terms of ocular surface parameters, a decrease in the width of LWE staining, from grade 2 (50-75% of the lid wiper) to grade 1 (25-50% of the lid wiper) (p=0.011) occurred in the 30-day period post-AM treatment and a decrease in ConjS approached significance (p=0.094).

A 1-week treatment with AM improved symptomatology scores by 33-43%.  Ocular surface signs associated with friction (lid wiper damage) also decreased by 38%. Hence, AM has a role in improving the quality-of-life of patients with intransient moderate-severe dry eye.