Herpetik Keratit ve Bakteriyel Keratitlerde Amniyotik Membran Transplantasyonu

Purpose: To evaluate the effect of amniotic membrane transplantation (AMT) in the treatment of corneal ulcers resulting from herpetic\udkeratitis (HK) and bacterial keratitis (BK).\udMaterial and Method: Forty-six patients (25 HK, 21 BK) treated with AMT for HK or BK-related corneal ulcers between January\ud2009 and September 2011 were followed prospectively. The visual acuities and ulcer characteristics (depth and localization) prior to\udAMT and epithelialization time, as well as final visual acuities after AMT, were evaluated.\udResults: The mean age was 51.9±17.0 years in HK and 53.3±22.0 years in BK and the mean follow-up time was 12.6±6.1 (5-33) months\udand 10.2±6.8 (3-27) months, respectively. The ulcers were mostly central in HK (72%) and paracentral in BK (52.4%) (p=0.03). Ulcer\uddepth was deeper than 1/2 of the cornea in 14 (56%) HK and in 7 (33.3%) BK (p=0.290). Eight HK patients had scars from previous\udherpetic keratitis episodes. The mean epithelialization time was 22.3±8.5 (12-50) days in HK and 22.1±10.9 (8-45) days in BK (p=0.488).\udWhile epithelialization was achieved in all the patients with BK, 3 HK patients needed adjunctive surgeries (conjunctival flap, tectonic\udpenetrating keratoplasty) in spite of three AMTs. Although visual acuities improved significantly in both groups, this improvement was\udmore evident in BK cases (p=0.018 for HK and p<0.001 for BK).\udDiscussion: Amniotic membrane transplantation is an effective and safe treatment for bacterial and herpetic corneal ulcers. The reason\udfor the lower final visual acuities in the herpetic group was thought to be related to a more central location, deeper involvement and scars\uddue to previous attacks.(Turk J Ophthalmol 2013; 43: 229-35