Freeze-Dried Amniotic Membrane Transplantation For The Management Of Infectious Keratitis

The purpose of this study was to assess the effects of Freeze-dried amniotic membrane transplantation (AMT) on clearing infection, corneal healing and visual improvement in infectious keratitis (IK).

This study was conducted in Mohamed 6 University hospital Tangier Morocco.

This is a prospective cohort study, involving all patients hospitalized for severe IK who underwent Freeze-dried amniotic membrane transplantation, for a period of 1 year and 10 months from January 2022 to October 2023. All patients had at least 3 months of follow-up.

The indications for AMT were severe corneal thinning, perforation or no improvement of IK with fortified drops.

Population demographics, follow-up time, IK etiologies, visual acuity, epithelial defect size, ulcer depth, corneal neovascularization and complications were assessed. Treatment success was defined as complete healing including disappearance of corneal infiltrates and epithelial defect closure.

AMT was performed in 27 eyes from 26 patients with an average age of 50 years. In 74% AMT was indicated for severe corneal thinning or perforation. The average time between the initial presentation and the graft was 9 days (4-17 days). The most surgical technique used was the multilayer AMT in 71%.  Recovery response was positive in 85%. Visual acuity improved from 2.18 Log Mar to 1.9 Log Mar.

Complications were observed in 3 patients, including endophthalmitis, phthisis bulbi, worsening of infectious keratitis.

Morocco currently experiences a lack of eye banks and availability of fresh amniotic membrane. Freeze-dried amniotic membrane transplantation was effective in the treatment of KI, accelerating cleansing and healing. Performing a transplant at early stages increases therapeutic success and shortens hospitalization time