A controlled study of amniotic membrane transplantation for acute Pseudomonas keratitis.

Abstract

OBJECTIVE:

To evaluate the efficacy of amniotic membrane transplantation (AMT) to improve the outcomes of acute Pseudomonas keratitis as compared with a control group.

DESIGN:

Prospective interventional case series with retrospective controls.

PARTICIPANTS:

We studied 14 eyes with Pseudomonas keratitis as the AMT group and 11 eyes with Pseudomonas keratitis as the control group.

METHODS:

Eyes in the AMT group were treated with antibiotic therapy followed by single-layer AMT at 2 to 3 days. Eyes in the control group received only antibiotic therapy. Patients were followed for 11.1 ± 2.4 months.

RESULTS:

In the AMT group, pain significantly decreased from a mean score of 2.4 ± 0.5 preoperatively to 1.1 ± 0.9 at day 2 postoperatively (p < 0.001). Corneal epithelial defects healed completely within 13.2 ± 2.6 days in the AMT group compared with 15.5 ± 3.4 days in the control group (p = 0.07). At final follow-up visits, the sizes of corneal opacity and deep neovascularization were not different between the 2 groups. However, the mean score for density of the corneal opacity was significantly less in the AMT group compared with the control group (2.1 ± 0.4 vs 2.5 ± 0.7, respectively, p = 0.04). Although the best corrected visual acuity using hard contact lenses was not different between the 2 groups, uncorrected visual acuity was better in the AMT group (0.45 ± 0.22 logMAR) than in the control group (0.71 ± 0.32 logMAR, p = 0.03). No patient in either group developed significant corneal thinning or perforation.

CONCLUSIONS:

AMT in acute Pseudomonas keratitis was associated with immediate pain relief, less density of the final corneal opacity, and better uncorrected visual acuity at the final follow-up visit.

• Authors: Ahmad Kheirkhah, Ali Tabatabaei, Mehdi Khodaparast Zavareh, Alireza Khodabandeh, Mehrdad Mohammadpour, Vadrevu K Raju
• Journal: Canadian journal of ophthalmology. Journal canadien d'ophtalmologie (Can J Ophthalmol) Vol. 47 Issue 3 Pg. 305-11 (Jun 2012) ISSN: 1715-3360 [Electronic] England
• PMID: 22687313 (Publication Type: Controlled Clinical Trial, Journal Article)
• Copyright: Copyright © 2012 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Ceftazidime

Topics

• Acute Disease
• Adolescent
• Adult
• Amnion (transplantation)
• Anti-Bacterial Agents (therapeutic use)
• Biological Dressings
• Ceftazidime (therapeutic use)
• Corneal Opacity (physiopathology)
• Corneal Ulcer (drug therapy, microbiology, surgery)
• Eye Infections, Bacterial (drug therapy, microbiology, surgery)
• Eye Pain (physiopathology)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prospective Studies
• Pseudomonas Infections (drug therapy, microbiology, surgery)
• Retrospective Studies
• Treatment Outcome
• Visual Acuity (physiology)
• Young Adult