title: Long-term efficacy of glycerine-processed amniotic membrane transplantation in patients with corneal ulcer.
abstract: OBJECTIVE
  The aim of this study was to determine the long-term treatment efficacy of glycerine-preserved human amniotic membrane transplantation in patients suffering from corneal ulcers.
  
  
  METHODS
  This was a retrospective, non-controlled, monocentric analysis. Included were patients with corneal ulcers that were non-responsive to ointment or contact lenses and had been treated by amniotic membrane transplantation with either the overlay or sandwich procedure. Analysis parameters were visual acuity before and following treatment, recurrence rate and subjective comfort at the last follow-up.
  
  
  RESULTS
  Of the 371 amniotic membrane transplantations that were conducted, 135 surgical treatments in 108 patients (51.9% male, 48.1% female; mean age 63.7 years) met the inclusion criteria. In total, 99 overlay and 36 multilayer amniotic membrane transplantations were performed. The follow-up period was 47.5 ± 66.7 weeks (mean ± SD). The recurrence rate at the last follow-up was 47.8% with overlay membranes and 51.8% with the sandwich technique. There was no significant change in best-corrected visual acuity following treatment with overlays (p = 0.219) or sandwich procedure (p = 0.703). At the last follow-up, 72.1% (overlay) and 78.3% (sandwich) of the patients reported either no pain or increased comfort.
  
  
  CONCLUSIONS
  The recurrence rates and changes in visual acuity following overlay or sandwich amniotic membrane transplantation in patients suffering from corneal ulcer were lower than reported elsewhere in the literature. More than half of the patients profited from each of the amniotic membrane transplantation techniques with respect to recurrence and postoperative comfort.
authors.affiliation: Department of Ophthalmology, University Medical Center, Muenster, Germany.
authors.forename: Constantin E
authors.initials: CE
authors.lastname: Uhlig
authors.affiliation: Department of Ophthalmology, University Medical Center, Muenster, Germany.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Frings
authors.affiliation: Department of Ophthalmology, University Medical Center, Muenster, Germany.
authors.forename: Nadine
authors.initials: N
authors.lastname: Rohloff
authors.affiliation: Department of Ophthalmology, University Medical Center, Muenster, Germany.
authors.forename: Christel
authors.initials: C
authors.lastname: Harmsen-Aasman
authors.affiliation: Department of Gynecology and Obstetrics, University Medical Center, Muenster, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Schmitz
authors.affiliation: Department of Gynecology and Obstetrics, University Medical Center, Muenster, Germany.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kiesel
authors.affiliation: Department of Ophthalmology, University Medical Center, Muenster, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Eter
authors.affiliation: Department of Ophthalmology, University Medical Center, Muenster, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Busse
authors.affiliation: Department of Ophthalmology, University Medical Center, Muenster, Germany.
authors.forename: Anne F
authors.initials: AF
authors.lastname: Alex
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000650:Amnion / Q000637:transplantation*; D001684:Biological Dressings; D002648:Child; D003320:Corneal Ulcer / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005990:Glycerol; D006801:Humans; D008297:Male; D008875:Middle Aged; D009757:Nylons; D019188:Organ Preservation Solutions; D012008:Recurrence; D012189:Retrospective Studies; D013536:Suture Techniques; D013537:Sutures; D014792:Visual Acuity / Q000502:physiology
chemical_list: D009757:Nylons; D019188:Organ Preservation Solutions; D005990:Glycerol
keywords: Neurotrophic ulcer; amniotic membrane transplantation; corneal ulcer; ocular surface disease; overlay; patch