Amniotic membrane inlay and overlay grafting for corneal epithelial defects and stromal ulcers

Objectives: To determine the effect of amniotic membrane transplantation (AMT) on persistent corneal epithelial defects (PEDs) and to compare the efficacy between inlay and overlay techniques. Methods: Thirty patients (30 eyes) underwent AMT for FED. The use of AMT was restricted to patients in whom all previous measures, including bandage contact lens and tarsorrhaphy, had failed. The amniotic membrane was placed on the surface of the cornea in overlay (group A) or inlay (group B) fashion. Results: The FED healed after the first AMT in 21 eyes (70%) within an average of 25.5 days after surgery and recurred in 6 eyes (29%). Among the 22 eyes treated with an overlay AMT (group A), the FED healed after the first AMT in 14 eyes (64%) within an average of 24.5 days and recurred in 4 eyes (29%). Among the 8 eyes treated with an inlay AMT (group B), the FED healed within an average of 27.4 days after AMT, which did not statistically significantly differ from group A (P = .72). The FED healed after the first AMT in 7 eyes (88%) and recurred in 2 (29%) of 7 eyes. Conclusions: The AMT can be helpful in the treatment of FED in which all other conventional management has failed. However, the success rate in our study was not as high as that previously reported, and our results showed a high incidence of recurrences of epithelial defects. We did not find any difference between overlay and inlay techniques in terms of healing time and recurrence rate.