title: Amniotic membrane inlay and overlay grafting for corneal epithelial defects and stromal ulcers.
abstract: OBJECTIVE
  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 PED. 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 PED 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 PED 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 PED healed within an average of 27.4 days after AMT, which did not statistically significantly differ from group A (P = .72). The PED 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 PED 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.
authors.affiliation: Immunology Service, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA.
authors.forename: E
authors.initials: E
authors.lastname: Letko
authors.forename: S U
authors.initials: SU
authors.lastname: Stechschulte
authors.forename: K R
authors.initials: KR
authors.lastname: Kenyon
authors.forename: N
authors.initials: N
authors.lastname: Sadeq
authors.forename: T R
authors.initials: TR
authors.lastname: Romero
authors.forename: C M
authors.initials: CM
authors.lastname: Samson
authors.forename: Q D
authors.initials: QD
authors.lastname: Nguyen
authors.forename: S L
authors.initials: SL
authors.lastname: Harper
authors.forename: J D
authors.initials: JD
authors.lastname: Primack
authors.forename: D T
authors.initials: DT
authors.lastname: Azar
authors.forename: M
authors.initials: M
authors.lastname: Gruterich
authors.forename: C H
authors.initials: CH
authors.lastname: Dohlman
authors.forename: S
authors.initials: S
authors.lastname: Baltatzis
authors.forename: C S
authors.initials: CS
authors.lastname: Foster
mesh_terms: D000328:Adult; D000368:Aged; D000650:Amnion / Q000637:transplantation*; D003319:Corneal Stroma / Q000473:pathology / Q000601:surgery*; D003320:Corneal Ulcer / Q000473:pathology / Q000601:surgery*; D019573:Epithelium, Corneal / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016378:Tissue Transplantation / Q000379:methods; D016896:Treatment Outcome; D014792:Visual Acuity; D014945:Wound Healing