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Amniotic membrane transplantation adds to benefits of antibiotics in bacterial keratitis
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The combination of amniotic membrane transplantation and antibiotic therapy leads to significantly better results than antibiotic therapy alone in eyes with bacterial keratitis, according to a study.
At Farabi Eye Hospital in Tehran, Iran, 49 eyes of 49 patients were treated with routine antibiotic therapy in combination with amniotic membrane transplantation, while 50 eyes of 50 patients received antibiotic therapy alone. Freshly prepared cefazolin 50 mg/mL and amikacin 14 mg/mL eye drops were administered every 2 hours in the first 3 days, followed by administration at the same interval during waking time only. Topical betamethasone 0.1% was also used four times a day and tapered over a 3- to 4-week period for all patients.
In the combination group, the amniotic membrane was placed on the cornea in a double layer, epithelium side up, and secured with 10-0 nylon sutures and a therapeutic contact lens.
Although corneal healing time and depth of corneal opacity were comparable in the two groups, the eyes that received amniotic membrane transplantation had smaller scar size, less neovascularization, and better best corrected and uncorrected visual acuity at 6 months. Density of Langerhans cells was comparable at 1 week but significantly less in the combination group at 1 month.
Amniotic membrane transplantation promotes healing by various mechanisms, such as the expression of anti-angiogenic factors, anti-inflammatory proteins, growth factors and protease inhibitors, and may act “as a biological bandage, providing a suitable substrate for epithelial cell migration, promoting epithelialization and inhibiting inflammation,” the authors said. – by Michela Cimberle
Disclosures: The authors report no relevant financial disclosures.
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