title: Sutureless amniotic membrane transplantation for severe bacterial keratitis.
abstract: OBJECTIVE
  To evaluate the efficacy of early sutureless amniotic membrane transplantation in the management of severe bacterial keratitis to reduce pain, inflammation, and haze, and to promote healing.
  
  
  METHODS
  A noncomparative case series including 3 eyes of 3 consecutive patients with severe bacterial keratitis exhibiting persistent epithelial defect/ulcer, more than 5 mm in diameter, located within 3mm from the visual axis with infiltration occupying more than 50% of the corneal thickness. They were retrospectively reviewed following early (ie, within 96 hours) sutureless amniotic membrane transplantation via ProKera together with selective topical antibiotics and preservative-free steroid. Pain relief, inflammation, haze, and corneal epithelial healing were monitored.
  
  
  RESULTS
  ProKera was inserted once in 1 eye and twice in the other 2 eyes. Pain was significantly relieved and inflammation was markedly reduced in all cases. The corneal epithelial defect and stromal ulceration rapidly healed while visual acuity improved in 2 of the 3 eyes.
  
  
  CONCLUSIONS
  Temporary sutureless amniotic membrane transplantation via ProKera allows easy insertion and replacement of the membrane in the office, as well as early intervention to promote epithelialization, reduce pain, haze and inflammation in cases with severe bacterial keratitis. This result justifies large series controlled studies in the future.
authors.affiliation: Ocular Surface Center, Miami, FL 33173, USA.
authors.forename: Hosam
authors.initials: H
authors.lastname: Sheha
authors.forename: Lingyi
authors.initials: L
authors.lastname: Liang
authors.forename: Jianjing
authors.initials: J
authors.lastname: Li
authors.forename: Scheffer C G
authors.initials: SC
authors.lastname: Tseng
mesh_terms: D000650:Amnion / Q000637:transplantation*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D011552:Pseudomonas Infections; D011550:Pseudomonas aeruginosa; D012720:Severity of Illness Index; D013203:Staphylococcal Infections; D013211:Staphylococcus aureus; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing