Sutureless Lyophilized Amniotic Membrane Grafting for Corneal Epithelial Defects

Objectives: To report the tolerability, safety, and efficacy of the lyophilized amniotic membrane (AM) Visio-AMTRIX placed under a bandage contact lens (BCL) in treating persistent epithelial defects (PEDs). Methods: This retrospective study included consecutive patients with PEDs treated with a lyophilized AM placed under the BCL. Patients with PEDs who did not respond to medical treatment were included. Patients with a follow-up time less than 3 months were excluded. Results: Eleven eyes of 11 patients (mean age, 61.6 +/- 15.9 years) were included. Time from PED presentation to AM transplantation (AMT) was 27.7 +/- 4.9 days, with the mean PED area of 13.2 +/- 11.3 mm(2). Complete resolution was achieved in 8 of 11 eyes after a single AM graft. The epithelial defect persisted after the first AMT in three eyes (27.3%), and a second graft was necessary to achieve complete healing. The corneal epithelial defect healed in an average of 11.0 +/- 4.4 days after grafting. After PED resolution, the best-corrected visual acuity significantly improved from 0.66 +/- 0.30 logMAR (20/91 Snellen) to 0.58 +/- 0.24 logMAR (20/77 Snellen) (P=0.036) compared with baseline. The AM resorbed within 2 weeks in all cases. No complication or recurrence was observed. Conclusions: A sutureless lyophilized AM under the BCL can resolve PEDs with a significant improvement in vision.