Efficacy of Amniotic Membrane Transplantation on Corneal Graft Rejection with Epithelial Defects after Penetrating Keratoplasty

In-Seong Kang; Yoon-Ha Kim; Tae-Bok Song; Jae-Kap Cho; Yeoung-Geol Park; Kyung-Chul Yoon

doi:10.4068/cmj.2009.45.1.55

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Kang, Kim, Song, Cho, Park, and Yoon: Efficacy of Amniotic Membrane Transplantation on Corneal Graft Rejection with Epithelial Defects after Penetrating Keratoplasty

Original Article

Chonnam Medical Journal

Chonnam Medical Journal 2009; 45(1): 55-59.

Published online: 27 April 2009

DOI: https://doi.org/10.4068/cmj.2009.45.1.55

Efficacy of Amniotic Membrane Transplantation on Corneal Graft Rejection with Epithelial Defects after Penetrating Keratoplasty

In-Seong Kang, Yoon-Ha Kim^1,², Tae-Bok Song^1,², Jae-Kap Cho³, Yeoung-Geol Park², Kyung-Chul Yoon²

Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea.

¹Department of Obstetrics and Gynecology, Chonnam National University Medical School and Hospital, Gwangju, Korea.

²Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.

³Department of Ophthalmology, Seonam Hospital, Seonam University, Gwangju, Korea.

kcyoon@chonnam.ac.kr

Accepted 5 November 2008

Abstract

We report the therapeutic effect of amniotic membrane transplantation (AMT) on corneal graft rejection with epithelial defects after penetrating keratoplasty (PKP). Twelve patients (12 eyes) who had epithelial and subepithelial graft rejection received human AMT, and they were compared with other 12 patients (12 eyes) who were treated with medication only. There were no differences in age, sex, time to rejection after PKP, and epithelial defect area between two groups. Time to epithelial healing and time to disappearance of rejection sign were significantly shorter in the AMT group (11.8±4.9 days and 15.5±6.3 days) than in the medical treatment group (19.0±3.7 days and 20.8±3.4 days)(p=0.01, p=0.02). AMT is effective in promoting epithelialization and improving inflammation of epithelial rejection after penetrating keratoplasty.

Keywords: Amniotic membrane transplantation, Graft rejection, Keratoplasty, Penetrating

Figures and Tables

Fig. 1

Comparison of time to epithelial healing and time to disappearance of rejection sign between the amniotic membrane transplanted group and the medical treatment group.

Fig. 2

Preoperative slit-lamp photograph demonstrated epithelial graft rejection showing large epithelial defect and subepithelial infiltration (A). Amniotic membrane was transplanted over the ocular surface (B). Eleven days after operation, the lesion healed with clear cornea (C).

Table 1

Characteristics of patients who were treated with amniotic membrane transplantation (AMT) and immunosuppressive agents for corneal graft rejection

AM, amniotic membrane; HSK, herpes simplex keratitis; PKP, penetrating keratoplasty.

Table 2

Characteristics of patients who were treated with immunosuppressive agents only for corneal graft rejection

HSK, herpes simplex keratitis; PKP, penetrating keratoplasty.

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