Amniotic Membrane Contact Lens: Effectiveness in Treating Persistent Keratoepithelial Defects Due to Wide Range of Ocular Surface Diseases

Monday, April 28, 2014: 8:26 AM
Room 154 (Boston Convention and Exhibition Center)
Marc Moore, MD, WANG VISION INSTITUTE, NASHVILLE, TN, USA
Sarah Y. Connolly, OD, Wang Vision Institute, Nashville, TN, USA
Ming X. Wang, MD, PhD, Wang Vision Institute, Nashville, Tennessee, USA

Narrative Responses:

Purpose
To assess the effectiveness of AmbioDisk amniotic membrane contact lens (AMCL) in treating persistent keratoepithelial defects (KED).

Methods
A retrospective review of 59 AMCL-treatment episodes for 44 eyes with persistent KED of 39 consecutive patients over an 18-month period was conducted. The patients were divided into a medical group (alkaline burn, herpes simplex, epithelial basement membrane disease, Sjogren’s syndrome, keratoconus) and a post-surgical group (after PTK and pterygium removal). The clinical protocol involved AMCL placement for 2 weeks, followed by additional AMCLs if clinically indicated. The number of AMCLs used and treatment duration for each KED episode were recorded.  The average number of AMCLs used and the average treatment duration per KED episode were then determined.

Results
Eighty-three AMCLs were used for 59 episodes of KED in 44 eyes. Overall, 50 episodes (84.7%) were successful, with an average of 1.4 AMCLs used and an average treatment period of 3.5 weeks per episode of KED. Nine episodes (15.3%) were failures, with an average of 1.4 AMCLs used and an average treatment period of 3.3 weeks.  In the medical group, 79.5% (35/44) achieved success with an average of 2.3 AMCLs used and an average treatment period of 5.7 weeks.  In the post-surgical group, 100% (15/15) of KEDs resolved with an average of 1.1 AMCLs used and an average treatment period of 2.8 weeks.

Conclusion
AmbioDisk AMCL was effective in promoting healing of persistent KEDs in a variety of ocular surface diseases and corneal surgeries. On average, 1-2 AMCLs were needed for KED healing over a 2-3 week period, but in eyes with advanced ocular surface diseases, AMCL treatment was required for 5-6 weeks.