To evaluate the effectiveness of cryopreserved amniotic membrane transplantation (AMT) in corneal ulceration.
The following electronic databases were searched: PubMed, EMBASE, and Cochrane Library. We evaluated the corneal epithelium healing rate (CEHR) and vision improvement rate (VIR) after AMT in the treatment of corneal ulceration. We analyzed the differences in the CEHR and VIR between the 2 groups of infective and noninfective corneal ulcerations. Subgroup analysis for the CEHR and VIR was performed based on the surgical methods. There were 3 subgroups: single-layered inlay, multilayered inlay, and sandwich (SAN). The differences were tested by referring to the Cochrane Handbook. Pooled estimates were determined with STATA software, version 15.
Eighteen eligible studies reporting the outcomes in 390 eyes of 385 patients were included. The results of the meta-analysis showed that the pooled CEHR was 97% (I2 = 37.9%, 95% confidence interval: 0.94–0.99, P = 0.089). The pooled VIR was 53% (I2 = 68.1%, 95% confidence interval: 0.42–0.65, P < 0.001). There were no significant differences in either the CEHR or the VIR between the 2 groups of infective and noninfective corneal ulcerations. Among the 3 subgroups of single-layered inlay, multilayered inlay, and SAN, the differences in both CEHR and VIR were statistically significant.
Consistent with many published reports, this meta-analysis also concluded that AMT was effective in the treatment of corneal ulceration. The curative effect of AMT was not different between the infective and noninfective corneal ulcerations. The differences in both CEHR and VIR were statistically significant among the subgroups.
*Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China;
†Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, China; and
‡Nankai University Affiliated Eye Hospital, Tianjin, China.
Correspondence: Xuan Li, MD, PhD, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Nankai University affiliated Eye Hospital, 4 Gansu Rd, Heping District, Tianjin 300020, China (e-mail: email@example.com).
Supported by grants from the National Natural Science Foundation of China (81170828), Tianjin Science & Technology Foundation (15JCZDJC35300), and Tianjin Health and Family Planning Communication Foundation (14KG133).
The authors have no conflicts of interest to disclose.
Received July 12, 2018
Received in revised form November 25, 2018
Accepted December 04, 2018