Outcomes Of Human Amniotic Membrane-Derived Dry Matrix For The Management Of Corneal Pathology
Published 2023 - 41st Congress of the ESCRS
Reference: PO0756 | Type: Free paper | DOI: 10.82333/e839-wb95
Authors: Haider Manzar* 1 , Amrita Saravanan 1 , Aida Hajjar Sese 1 , Lazha Sharief 1 , Lucia Pelosini 1
1Ophthalmology,King's College Hospital NHS Foundation Trust,London,United Kingdom
Purpose
To report the outcomes human amniotic membrane-derived dry matrix (AMDDM, Omnigen® NuVision Biotherapies) in the management of corneal pathology of various etiologies.
Setting
The study was performed in the Ophthalmology Department of King’s College Hospital NHS Foundation Trust between August 2018 and January 2023.
Methods
A retrospective cohort study consisting of 18 patients (20 eyes) treated with AMDDM (Omnigen®) for severe ocular surface disease of different etiologies in one centre. The study included patients with persistent epithelial defects (PED), pseudophakic painful bullous keratopathy, impending corneal perforations.
The main outcome measures of the study included: baseline visual acuity (VA), final VA, time for the corneal epithelium to heal, time to the removal of the bandage contact lens (BCL), subjective grading of baseline pain (1-3, 1=mild; 2=moderate; 3=severe), subjective grading of final pain (1-3, 1=mild; 2=moderate; 3=severe) and the incidence of further surgical interventions.
Results
A total of 20 eyes of 18 patients (12 females; 8 males), age range 21 to 93 years (average age 68 years), received AMDDM transplant for PED secondary to neurotrophic keratitis (14 eyes), painful bullous keratopathy (5 eyes), impending perforation after microbial keratitis (1 eyes).
AMDDM transplant led to complete healing in 60% of eyes, 20% of eyes required further surgery (1 evisceration, 1 DSAEK, 1 PKP, 1 ALK), 20% eyes required a second AMDDM transplant.
The VA improved by an average of 3 lines (range 1-7 lines) in 45% of eyes, the average healing time was 9 weeks, the average time to BCL removal was 9 weeks. The subjective grading of pain showed complete resolution of pain in 65% and a significant reduction in pain in 35%.
Conclusions
AMDDM has proven to be an effective option in advanced corneal pathology to treat persistent epithelial defects and painful bullous keratopathy. Although visual acuity may not show significant improvement in all cases, patients all report a subjective significant reduction or complete reduction of ocular pain after AMDDM transplant. Furthermore, the application of AMDDM is a minimally invasive procedure that is performed on topical anesthesia with a short theatre time and a high safety profile.