Comparative evaluation of combined and traditional (suture) methods of amnion fixation in surgical treatment of persistent corneal erosion

Purpose. to compare the traditional suture and combined methods of amniotic membrane (AM) fixation during the surgical treatment of persistent corneal erosion (PER). Material and methods. The study was carried out on 50 patients (54 eyes). All eyes were divided into 2 groups: experimental (combined method of AM fixation using sutures and two-component autofibrin glue (DAPK)) and control (fixation with sutures). A comparative assessment was carried out: the period of AM lysis, the area of corneal epithelium defects before and after surgery, the presence/absence of OCT signs of inadequate adhesion of AM to the ocular surface, the quality and comfort of the surgical manual based on the results of the surgeons' questionnaire. Results. Before the start of surgical treatment of PER, the mean area of erosion in the study group was 27.5 (19.3; 32.8) mm2, in the control group — 32.6 (20.5; 36.5) mm2, the main causes of PER: corneal injuries and burns, high-risk keratoplasty, PER after repeated vitreoretinal interventions. The compared groups were homogeneous in these characteristics. The average duration of operations in the study group was 19 (17; 21) minutes, in the control group — 30 (25; The mean period of AM lysis in the study group was 10 (9; 12) days, in the control group — 7 (7; 9) days. The area of erosion in the study group at the end of treatment was 4.3 (2.4; 5.3), in the control group — 9.7 (7.5; 12.8). The formation of AM folds was observed only in the control group (in 40 % of cases). Incomplete adhesion of AM to the ocular surface in the study group was observed in 15.3 % of cases, in the control group — in 53.3 %. Conclusion. The study showed not only the possibility, but also the significantly higher clinical efficacy, convenience and reliability of the proposed combined method of fixation of AM to the ocular surface in the treatment of persistent corneal erosions of various etiologies. Keywords: persistent corneal erosion, amniotic membrane, methods of amniotic membrane fixation