Comparison Between Amniotic Membrane Transplant And Tarsorrhaphy In The Management Of Persistent Corneal Epithelial Defects In A Tertiary Eye Care Center In Riyadh, Saudi Arabia.

Published 2025 - 43rd Congress of the ESCRS

Reference: PO957 | Type: Poster | DOI: 10.82333/bywm-2517

Authors: Musa AlRashedi ¹ , Abdulrahman Alasqah* ¹ , Khaled AlDihan ¹ , Rawan Hawsawi ¹ , Hamad AlSulaiman ¹

¹King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia

Purpose

This study aimed to compare the efficacy and safety of amniotic membrane transplantation (AMT) versus tarsorrhaphy in managing persistent corneal epithelial defects (PED) refractory to medical therapy. The primary objective was to evaluate the proportion of patients achieving complete PED healing at 1, 2, 3, and 6 months post-intervention. Secondary objectives included assessing the time to healing, recurrence rates, and postoperative complications (e.g., microbial keratitis, corneal scarring) between the two surgical approaches.

Setting

This retrospective study was conducted at King Khaled Eye Specialist Hospital (KKESH), a tertiary eye care center in Riyadh, Saudi Arabia. Data were collected from electronic medical records of patients treated between January 2018 and December 2021. Ethical approval was obtained from the KKESH Institutional Review Board (IRB) prior to data extraction.

Methods

We reviewed records of all patients with PED (defined as an epithelial defect persisting beyond 14 days despite maximum medical therapy) who underwent either AMT or tarsorrhaphy. Data collected included demographics (age, gender), comorbidities (e.g., diabetes, hypertension), PED etiology (e.g., exposure keratopathy, microbial keratitis), size (mm), and duration (days), intervention type, and outcomes at 1, 2, 3, and 6 months post-procedure. Tarsorrhaphy was performed as either a temporary (reversible) or permanent lid closure procedure while AMT involved placement of a cryopreserved amniotic membrane over the defect, secured with sutures or fibrin glue. Complications included recurrent PED, microbial keratitis, and corneal scarring.

Results

Of 67 eyes, 37 underwent AMT (median age is 65; 57% male) and 30 received tarsorrhaphy (median age is 69 ; 80% male). At presentation, exposure keratopathy was more common in the tarsorrhaphy group (40% vs. 2.7%; p<0.001), while microbial keratitis predominated in the AMT group (57% vs. 20%; p=0.002). Healing rates increased over time in both groups. At 1 month, 59% (22/37) of AMT group and 50% (15/30) of tarsorrhaphy group healed (p=0.43); by 6 months, these figures were 86% (32/37) and 70% (21/30), respectively (p=0.10). Complications included recurrent PED (2.7% AMT vs. 6.7% tarsorrhaphy; p=0.6) and microbial keratitis (2.7% in both; p=0.6). Corneal scarring was significantly higher in the tarsorrhaphy group (37% vs. 8.1%; p=0.004).

Conclusions

Both AMT and tarsorrhaphy effectively promoted PED healing, with 86% and 70% of patients achieving complete epithelial closure by 6 months, respectively. Although AMT showed a numerically higher healing rate, the difference was not statistically significant (p=0.10). Complication profiles differed, with tarsorrhaphy linked to more corneal scarring, possibly due to its association with exposure keratopathy. The retrospective design and etiological disparities between groups limit definitive conclusions. Future prospective studies with standardized treatment allocation and adjusted analyses are warranted to clarify these findings.